If you suffer from sleep apnea, you’ll know it can be seriously disruptive to your health and day-to-day life. The common sleep disorder, which affects around 24 million Americans, can cause issues such as exhaustion and several long-term health problems.^1,2 Globally, it is estimated that 936 million adults aged 30–69 years (men and women) have mild to severe obstructive sleep apnea (OSA) and 425 million adults aged 30–69 years have moderate to severe OSA.³

While treatments such as continuous positive airway pressure (CPAP) therapy alternative treatments work for many people, some end up needing surgical treatment.⁴ Several surgical options are available to treat sleep apnea, but they’re usually only recommended when other methods have failed.

Who needs sleep apnea surgery? 

Surgery is an invasive option that comes with a level of risk – that’s why it may only be recommended if other treatments have not worked. CPAP therapy is highly effective if used correctly and consistently.⁵ Mouth guards and other oral appliances can reduce the effects of sleep apnea but have inconsistent-use rates if they are uncomfortable or ill-fitting.⁶

If you are struggling to get results from your initial sleep apnea treatment, you will be encouraged to keep trying before you resort to surgery. 

How does sleep apnea surgery work? 

There is no one type of surgery that can solve the problem for every person. The specific surgery for you will depend on the reason for your apnea – focusing on your airway and throat, tongue, jaw or nose. 

Here are the most common types of sleep apnea surgery: 

Mouth, throat and windpipe  

Uvulopalatopharyngoplasty (UPPP) or upper airway surgery

Upper airway surgery is the most common surgical treatment for OSA.⁷ Used since the 1980s, it involves removing or reshaping the uvula, soft palate and tonsils. The surgery usually entails a general anesthetic, overnight hospital stay, and two to three weeks’ recovery. 

Laser-assisted UPPP (LAUP) 

Laser-assisted UPPP surgery involves using a laser to target key parts of the uvula, tonsils or soft palate. While it’s less invasive than traditional surgery, studies have found potential side effects, so it’s rarely recommended as an option.⁸ 

Tonsillectomy

Enlarged tonsils can be a factor in OSA, which is why tonsil removal is sometimes recommended as a surgical option. It has been found to be an effective treatment for adults with sleep apnea caused by enlarged tonsils.⁹ The surgery involves a general anesthetic and one to two weeks of recovery.

Jaw surgery 

Maxillomandibular advancement (MMA) 

In this type of surgery, the lower jaw is moved forward, opening the space at the back of the throat to allow for a clearer airway during sleep. While the surgery is invasive, it can also be successful. Like other apnea surgeries, MMA requires a general anesthetic, an overnight stay, and a recovery time of four to six weeks.

Nasal surgeries 

Although it’s less common, surgery on the nose is sometimes used as a treatment for sleep apnea. Nasal surgeries usually involve a general anesthetic and recovery time. 

Rhinoplasty 

Rhinoplasty, more often a cosmetic surgery, alters the structure and shape of the nose. It can help with sleep apnea in cases where the shape of the nose obstructs breathing. 

Septoplasty 

In some people, the nasal septum – the layer of bone and cartilage between the nostrils – is distorted or deviated, making breathing difficult. Septoplasty surgery straightens the septum, clearing the nostrils. This can help with sleep apnea in cases where the septum of the nose obstructs breathing. 

Endoscopic sinus surgery 

This surgery, often used as a treatment for people with allergies, removes tissues in and around the sinuses. These tissues can stop the sinuses from draining, which can also impact the airway. In some cases, this surgery may help with sleep apnea.

Nasal valve surgery 

In some people, the narrowest point of the nasal passage can close off or shrink during sleep. This surgery keeps the nasal valve open at all times, preventing obstruction, which may contribute to sleep apnea.  

Turbinate surgery 

During this procedure, the surgeon removes or shrinks bony structures inside the nose – called turbinates. These structures can obstruct the nose and make breathing difficult, contributing to sleep apnea in some cases. 

Tongue surgeries 

Genioglossus advancement (GGM) 

The muscle at the back of the tongue, known as the genioglossus, can slip back during sleep and block your airway. GGM surgery involves moving the muscle forward so it’s less likely to obstruct your breathing. While the surgery involves a general anesthetic and hospital stay, it’s reasonably effective, with a 39-78% success rate.⁸ 

Midline glossectomy

Unlike GGM surgery, which moves the tongue forward, this procedure removes tissue from the base of the tongue. The surgeon may do this with a laser, radiofrequency waves or even a robotic surgical assistant. Midline glossectomy is usually performed along with other procedures, e.g., tonsillectomy or UPPP surgeries, and may help relieve sleep apnea.⁸

Hyoid suspension 

The hyoid is a bone at the back of the neck that connects to the tongue muscles. Hyoid surgery moves the bone, which helps move the tongue forward to open the airway. It’s often performed along with other sleep apnea treatments, including UPPP surgery. One study found that UPPP with hyoid suspension was more effective than UPPP alone.¹⁰ 

Sleep apnea surgery – the benefits     

Despite the risks, many people do choose to go ahead with sleep apnea surgery if other treatments don’t work. Different surgeries have different success rates, making it difficult to predict effectiveness across the board. It all depends on your specific anatomy, the factors driving your sleep apnea and the procedures your surgeon recommends.

Sleep apnea surgery – the risks   

As with any surgery, sleep apnea procedures come with potential downsides:¹¹ 

• Infection or other complications following surgery. 
• Recovery time of 2 to 6 weeks, depending on procedure. 
• Risk associated with anesthetics and other medications. 
• Outcome may be less effective than expected. 
• Some people still need to use CPAP or other therapies after surgery. 

CPAP troubleshooting

CPAP therapy is effective for many people with sleep apnea, but some people find it difficult to adjust to therapy. Often, this comes down to a mismatch with equipment or some simple tweaks to your settings.  This means talking to your doctor or device provider, swapping out key pieces of equipment, and adjusting settings to make the therapy as comfortable as possible. It can also involve giving yourself time to adjust to your CPAP machine – it takes some people a while to get used to the feeling of a mask during sleep. 

Take a look at our CPAP Troubleshooting Guide and our Getting used to CPAP articles for guidance. 

The content is for educational purposes only. It should not be used as a substitute for the medical advice of one’s healthcare provider.