A Sad Day for Sleep Medicine

Dr. Christian Guilleminault

I was extremely saddened to hear that Dr. Christian Guilleminault, one of the major pioneers in the field of sleep medicine, recent passed away at the age of 80. He was the first to coin the term, obstructive sleep apnea syndrome. A prolific researcher with countless publications, he was a mentor and friend to numerous sleep medicine and other related healthcare professionals. 

Dr. Guilleminault radically changed my perspective on how I look at sleep apnea when I read his landmark article on upper airway resistance syndrome (UARS). He showed in sleepy, thin young men and women that they can stop breathing and wake up dozens of time every hour without meeting the formal criteria for apneas. This was shown using esophageal pressure catheters, which detected progressively lower chest pressures with successive breaths, ending with brain wave arousals from deep to light sleep.

UARS patients present differently from classic sleep apnea patients, with severe chronic fatigue (but not drowsiness), headaches, anxiety depression, low blood pressure, cold hands and feet, hypothyroidism, or digestive issues. 

He was also one of the first to describe sleep apnea in young children, attributed sleep-walking to sleep apnea, and was instrumental in collaborating with surgeons at Stanford University legitimizing surgical options for sleep apnea. He was influential in shifting sleep doctors’ thinking from looking at sleep apnea mainly due to obesity to craniofacial factors. 

I was privileged to have interviewed Dr. Guilleminault about UARS many years ago on my podcast. To hear the recording, please click here.

Thank you Dr. Guillminault for opening my eyes to the importance of good breathing for good sleep. 

Please note: I reserve the right to delete comments that are offensive or off-topic.

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One thought on “A Sad Day for Sleep Medicine

  1. I too am thankful for the many contributions of Dr. Christian Guilleminault to our health. But I think he is in a better place and going onward to make further contributions.

    But when I think about sleep apnea and especially Upper Airway Resistance Syndrome (UARS) I find my mind flashing to another of your interviews actually with Dr. Ronald M. Harper. If I recall he posits that the damage which causes sleep apena begins in the brain. Well now the physical and neurological are interrelated I suppose.

    I wonder if perhaps a third factor comes along to play with the afore mentioned. I remember getting “tension headaches”. My neck muscles were clearly in a knot and if someone was kind enough to massage them the headache would go away.

    About three years into my use of CPAP an encounter with a violent mugger resulted in me also dealing with post traumatic stress issues. I was fortunate during that time to hear your interview with Buteyko breathing instructor Patrick Mckeown. This made it clear to me that the ventilatory instability issues with using CPAP were now much greater for me.

    During the hundreds of hours I then spent in the medical literature I became aware of the areas in the brain which control breathing. Many of them are in the “base of the brain” whose blood supply derives from the vertebral arteries with perhaps half of us having a connection to the internal carotid arteries through the posterior communicating arteries. I have also come to believe that I am not one of those who have the connection through the posterior communicating arteries. So perhaps those “tension headaches” were the result of the extra pressure on my neck vertebrae also compressing the vertebral arteries and so starving the base of my brain? I have found that when I am breathing more than is appropriate for the situation simply correcting my head and spine posture calms that right down. The blood supply to the base of the brain appears to be very important to ventilatory control.

    Yet all of this was not so much of an issue to me until my stress levels rose. But are there other kinds of stress that could do the same thing? How about toxins.

    I was on a photo shoot at Steptoe Butte but on the way back a crop duster came so close I thought we might collide. The car was filled with the insecticide. And I spent the next six or so weeks in bed with a headache that very much reminded me of those “tension headaches” I used to have. Indeed I had ten out of ten of the symptoms I could find of moderate organophosphate poisoning. The response of my leg muscles is such that if I do not do stretching of my hamstrings and glutes my back will suffer.

    Insecticides, herbicides, and flame retardants are well known to affect brain functioning. In the context of our societal nutrient deficiency I simply wonder could these chemicals be causing changes to the brain which result in sleep apnea? Is the brain changed and then chronic (or intermittent) inflammation of the tissues what sets sleep apnea to be? I wonder.