In Memoriam| Volume 5, ISSUE 6, P530-531, December 2019

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Christian Guilleminault

Published:November 01, 2019DOI:
      Christian Guilleminault pioneered sleep medicine and changed the world. He died from metastatic cancer in California on July 9, 2019. He was born in Marseille, France, in 1938, completed medical school at the University of Paris, and was trained in psychiatry and neurology in Paris and Geneva. He was recruited to Stanford in 1972 because of his interest in obstructive sleep apnea and would go on to become known throughout the world as “C.G.”. When Guilleminault arrived, he revamped the fledging Stanford Sleep Disorders Clinic, envisioning a new discipline of sleep medicine. He foresaw a sleep-medicine practice structured like internal medicine, requiring a systematic, broad clinical approach that sought to understand sleep across the lifespan. Once Guilleminault arrived, in the words of Dr. William Dement, the Stanford Sleep Clinic “took off.” The clinical approach that Guilleminault established became the model for all sleep medicine worldwide. He pioneered the clinical and laboratory practices and developed the detailed history and examination approaches upon which accreditation standards in sleep medicine would be established.
      Guilleminault's dedication to the field of clinical sleep medicine was absolute and all inclusive. Following his vision, from its humble beginnings, the Stanford sleep clinic evaluated not only adults but also children of all ages. Over the course of his career, Guilleminault pushed the field to greater engagement in the identification of not just sleep disorders but also therapy. As a clinician and researcher, he was relentless in his pursuit of improving patient outcomes, seeking to understand why some treatments failed, challenging emerging dogma in the service of better therapies, and ultimately envisioning how to prevent such conditions in the first place.
      Guilleminault was the most prolific author in the sleep field and an innovative researcher whose contributions advanced the field of sleep medicine. For those who knew him personally, it quickly became apparent that he had the ability to grasp not only the nuances of any project he would work on but also, and perhaps more importantly, its larger impact. This unique intellect was instrumental in allowing him to be the first person to describe the “obstructive sleep apnea syndrome.” He was also the first to report on the condition in children. Guilleminault was a founding member of the Association of Sleep Disorders Centers in 1975, and in 1977, Guilleminault and Dement founded the journal Sleep, the official publication of the Sleep Research Society. Guilleminault served as the editor-in-chief until 1998. He proceeded to describe upper airway resistance syndrome (UARS) in children in 1982, noting that the condition was associated with symptoms of attention deficit, hyperactivity, and abnormal behavior during wakefulness and sleep, learning disabilities, and parasomnias. He also described UARS in adults. Along with Dement, he developed the apnea-hypopnea index (AHI). He coauthored more than 745 journal articles on sleep apnea, narcolepsy, sudden infant death syndrome, snoring, upper airway resistance syndrome, and neurological disorders of sleep. He was conferred honorary titles at the Medical Sciences School of Capital Medical University in Beijing, China, and the University of Liege, Belgium, and was recipient of awards from the World Association of Sleep Medicine and the Sleep Research Society; he also received a Lifetime Achievement Award from the National Sleep Foundation in 2005.
      Guilleminault was equally a champion of sleep medicine education and was a devoted teacher, mentor, and champion of students, residents, and fellows as well as colleagues. Students from around the world came to Stanford to learn under his aegis. Fittingly, a great many of his students went on to develop well-established, illustrious careers in sleep medicine across the world. He was especially beloved by generations of sleep medicine fellows at Stanford, for whom he was not just a fixture, but an inspiration. He encouraged diversity, engagement, and inclusion before these were buzzwords. He was extraordinarily active in his clinical practice during his entire career and was an exceptional bedside teacher who taught hundreds of sleep medicine physicians the nuances of clinical observation and polysomnographic interpretation. For those of us who were fortunate enough to work with him on a daily basis, C.G.'s incredible work ethic was paired with a keen sense of humor and an indelible charm. He was known to motivate trainees with the threat of the “guillotine” – so beloved an expression that in 2008 his fellows commissioned a miniature, working guillotine for him. It became one of his treasured possessions on display for those visiting his office. C.G. inspired us all to think differently, to be open-minded, and to pursue answers to important questions, despite the difficulty of doing so.
      A leader among leaders, Christian Guilleminault, embodied the spirit, dedication, and drive for excellence and discovery, with a singular focus to improve the sleep and the lives of patients everywhere. His imagination was boundless, and while he is no longer with us in person, his spirit will live on in our work and will continue to inspire the imagination of the sleep community for generations to come.
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      Figure 1Christian's beloved guillotine, a gift from his 2008 class of fellows. C.G. would often joke they had “No hope”. So the fellows had it inscribed at the top.