Season 7 | Episode 22
In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Dave Singh, a former Adjunct Professor in Sleep Medicine at Stanford University, with a PhD in craniofacial cleft palate development, and a third PhD in orthodontics, to explore the evolving field of craniofacial sleep medicine. As founder of REMA Sleep based in North Carolina, Dr. Singh introduces the concept of craniofacial sleep medicine—an etiology-based approach to treating obstructive sleep apnea guided by anthropomorphic features rather than solely AHI severity metrics.
Craniofacial sleep medicine represents a paradigm shift from license-based treatment allocation to collaborative, anatomy-driven care where dentists, surgeons, and sleep physicians work together to determine the most appropriate interventions based on individual structural characteristics. Dr. Singh explains why understanding craniofacial structures is crucial for personalizing OSA treatment, including why Asian populations show high OSA prevalence despite lower obesity rates.
The conversation provides a comprehensive crash course in assessing craniofacial anatomy: What is retrognathia and what causes it? How can clinicians alter jaw position by adjusting cranial base morphology? He discusses critical anatomical considerations including tongue positioning at rest and during sleep, lateral pharyngeal wall collapse, and cervical vertebrae influence on airway patency.
The episode explores both preventive approaches in children and interventions for adults, addressing whether craniofacial modifications require surgery or can be achieved through other means. Dr. Singh discusses palatal expansion, tongue traction techniques, and the physiological components that remain addressable even after skeletal maturity. He also explains age-related changes including loss of muscle tone, bone volume reduction, and maxillary drift that progressively narrow the airway.
Intriguing topics include the mechanisms behind why didgeridoo playing and conch shell blowing improve sleep apnea, the role of oromyofunctional therapy as a viable treatment option, evolutionary changes in human dentition that impact airway anatomy, and even the dental stem cell implications for regenerative approaches. Dr. Singh also clarifies surprising facts, such as why mouthguards in contact sports serve purposes beyond tooth protection.
Whether you’re seeking to understand anatomical contributors to OSA beyond obesity, interested in multidisciplinary treatment approaches, or curious about how craniofacial structure influences treatment selection, this episode provides essential insights into personalized, anatomy-based sleep apnea management.
Join us for this fascinating exploration of how form determines function in the upper airway and how understanding craniofacial anatomy can revolutionize OSA treatment strategies.
Dr. Dave Singh
Professor G. Dave Singh is a US citizen who was born, educated and trained in England, UK. He holds three doctorates, including Doctor of Dental Medicine; a Ph.D. in craniofacial cleft palate development; and a third Doctorate in Orthodontics. Previously, he was awarded a postgraduate grant (University of Oxford, UK) and was later appointed to the Board of Examiners, Royal College of Surgeons of England. Supported by Harvard University, the University of Michigan, and the University of Hawaii, he was invited to relocate to the Center for Craniofacial Disorders, University of Puerto Rico, USA where he led a NIH-funded program of clinical craniofacial research. He has published over 220 articles in the peer-reviewed medical, dental and orthodontic literature, has published 9 books/chapters and has had over 20 US, Canadian, European and international patents issued. During 2008-2016, Dr Singh was the Founder and CEO of his start-up company, which was successfully listed on NASDAQ after its IPO in 2020. In 2019, Dr. Singh was the recipient of the US Invisible Disabilities Association award. In 2020, Dr Singh was given a lifetime achievement award for his work on obstructive sleep apnea. Dr Singh is the inventor of the DNA appliance, which was the first palatal expander to be FDA approved for the treatment of mild-moderate as well as severe obstructive sleep apnea in both adults and children. During 2021-2025, Dr Singh was an Adjunct Professor in Sleep Medicine at Stanford University, USA.
