Surgery can help improve some cases of obstructive sleep apnea by removing or reducing the obstruction.

Sleep apnea is a common condition. Several potential treatment options may help, including surgical procedures. Surgery can reduce the obstruction that causes the person to stop breathing while they sleep.

This article reviews what sleep apnea is and several of the surgeries that can help improve the condition.

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Sleep apnea is when a person’s breathing stops and starts several times as they sleep. It is a common condition that can prevent the body from getting enough oxygen.

The two types of sleep apnea are:

  • Central sleep apnea (CSA): This occurs when the brain does not send signals to the lungs to breathe. It often results from underlying health conditions that affect the brain.
  • Obstructive sleep apnea (OSA): This is the more common type where the airways become blocked periodically due to factors such as hormones, enlarged tonsils, or obesity.

Learn more about the types of sleep apnea here.

A doctor can diagnose sleep apnea with a sleep diary or a sleep study called polysomnography. During polysomnography, a healthcare professional connects a person to equipment that measures their breathing and other functions.

Doctors use the results to rule out other sleep disorders before diagnosing sleep apnea.

Learn more about polysomnography here.

Surgery is usually not an option for people with central sleep apnea, and doctors only recommend it for people with mild to moderate OSA.

However, researchers have reported promising results using a “fully implantable unilateral transvenous phrenic nerve stimulation (TPNS) device” to improve central sleep apnea symptoms. Research into this treatment is ongoing.

Doctors can sometimes treat obstructive sleep apnea with surgery. A surgeon needs to know the exact cause of the condition so they can perform one of the following types of surgery:

Nasal surgery

Nasal surgery can help reduce obstructions to the airways in the nose. Sleep apnea can happen if there is a blockage in one of the following parts of the nose:

  • nasal valve
  • septum
  • turbinates

The most common nasal surgeries to address sleep apnea are septoplasty and turbinate reduction. These outpatient procedures are generally safe. They can improve sleep apnea symptoms by enlarging the septum or turbinates to allow air to flow freely through them.

Palate surgery

For mild cases of sleep apnea, a doctor may recommend soft palate surgery, also known as the Pillar Procedure. This outpatient procedure involves placing three plastic rods into the soft palate tissue.

The rods stimulate an inflammatory response in the tissue, which helps to stiffen it. When this occurs, the firm palate tissue is less likely to rub into the pharynx, which can help improve sleep apnea and snoring.

Uvulopalatopharyngoplasty (UPPP)

Uvulopalatopharyngoplasty (UPPP) is the most common surgical procedure performed for sleep apnea. During the procedure, a surgeon removes excess tissue from the pharynx and soft palate as well as the tonsils if they are present. They then close up the incisions.

The treated area is known as the oropharynx, and it is responsible for the majority of sleep apnea cases.

The procedure requires an overnight hospital stay and may involve a painful recovery.

Adenoid or tonsil removal

For children with sleep apnea, doctors often recommend adenotonsillectomy. In this procedure, the surgeon removes the adenoids and tonsils. Removing these structures can open up the airways and improve sleep apnea.

According to a 2016 study, children who are not obese and have smaller tonsils may find that recovery and risk are lower if just the adenoids get removed. However, if the tonsils are larger, the surgery may not be as effective as removing both.

Skeletal Surgery

If a malformation of the maxillofacial skeleton has occurred, a doctor may recommend skeletal surgery to correct the issue. The procedure involves expanding the jaw by about 10–12 millimeters (mm) and then stabilizing it with titanium plates.

The procedure is relatively complicated compared to other surgeries due to needing to cut bone precisely and align teeth properly. As part of recovery, the person will need their teeth wired shut and several nights in the hospital.

However, the procedure has a nearly 90% success rate, though few surgeons or facilities perform this surgery due to the complication of the procedure and recovery.

Tongue surgery

There are two different procedures involving the tongue. They include:

  • Tongue advancement: In this procedure, a surgeon moves the primary muscle of the tongue (genioglossus muscle) forward. They make a cut into the jaw bone, move it forward, and then use a titanium plate to keep it in place. Though generally effective, it requires an overnight stay and is more invasive than other interventions.
  • Tongue base reduction: Tongue base reduction is a procedure that decreases the amount of tissue in the tongue’s base. A surgeon can do it either with an incision or by using radiofrequency waves. The incision surgery (midline glossectomy) is more invasive and requires an overnight hospital stay. The radiofrequency method is noninvasive but requires several sessions. Both can improve, but not necessarily cure, mild sleep apnea in about 60% of people.

Tracheostomy

In individuals with obesity, a tracheostomy may provide effective relief from sleep apnea. The procedure involves creating an opening to the trachea through the neck to allow oxygen a direct route to the lungs. Doctors sometimes recommend it for people who have tried other treatments without success.

All surgical procedures have some risks associated with them. A person should talk with a doctor about the risks associated with the treatment option they recommend.

Any procedures that require general anesthesia put a person at greater risk. This is due to its effects on breathing, which can make regaining consciousness more difficult. It can also make it harder for a person to breathe following the procedure.

Doctors will closely monitor a person during surgery to prevent risks from general anesthesia.

Other general risks of surgery include:

Learn more about general anesthesia here.

Below are answers to some commonly asked questions about surgery for sleep apnea.

Does surgery cure sleep apnea?

For some, surgery can cure or stop sleep apnea. Though many surgeries have high success rates, no procedure can guarantee to cure sleep apnea.

Are there other treatments for sleep apnea?

The first-line treatment for sleep apnea is continuous positive airway pressure (CPAP). CPAP involves a person wearing a mask over their mouth and nose that is connected to a machine. The machine delivers a constant flow of air to a person’s airways to help keep them open.

Doctors rarely recommend surgery to treat sleep apnea. A person may improve their sleep apnea in the following ways:

  • making lifestyle changes, such as maintaining a healthy weight, limiting alcohol, stopping smoking, staying active, and eating a healthy diet
  • using oral devices to open the mouth wider
  • doing exercises for the mouth and jaw area

A person should talk with a doctor about their expectations following the procedure. Most of the procedures have a high level of success, though not everyone will see improvement following surgery.

If one surgical procedure does not work, a person’s doctor will likely recommend additional treatments.

Several surgical procedures can help improve sleep apnea. Some are minimally invasive outpatient procedures, while others require a hospital stay.

The surgery a doctor recommends will vary based on the underlying cause of sleep apnea. A person should discuss their options with a doctor and ask about the likelihood of success.

The most common surgeries for sleep apnea are generally safe. Surgery that requires general anesthesia is associated with higher risks.