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August 2020 |  Reviewed by: Shelley Hershner, MD and Reeba Mathew, MD

What is surgery?

Surgery may be a part of the treatment plan for some patients with sleep apnea or snoring. Your sleep team may recommend surgery if you can’t tolerate CPAP therapy, which is the most effective treatment option for sleep apnea.

Some surgeries are minimally invasive, while others are more complex. The goal of surgery is to treat the areas of the airway that collapse and block your breathing during sleep. Surgery may stiffen, remove or reposition tissues in and around your throat. These surgeries may focus on the:

  • Soft palate and uvula
  • Tonsils and adenoids
  • Tongue
  • Upper and lower jaw

Weight loss surgery may also help treat sleep apnea in patients who are extremely obese.

Treating sleep apnea through surgery is a team effort. Your sleep doctor works with a sleep team to provide the highest quality of care.

The sleep doctor will detect and diagnose your sleep apnea. He or she will perform a detailed examination of the entire upper airway before discussing your treatment options. The doctor may direct you to a surgeon (otolaryngologist) or an oral surgeon (oral maxillofacial surgeon) to perform the surgery. After the surgery is complete, you will need to follow up with your sleep doctor. Typically a repeat sleep study will be done to see if the sleep apnea has improved or resolved.

If you are considering surgery to treat your sleep apnea, make sure to ask your doctor the following questions:

  • What is the success rate of the surgery?
  • How long will it take to recover?
  • How much school or work will I miss?
  • How will this procedure improve my snoring or sleep apnea?
  • Why is surgery a better option for me than CPAP or oral appliance therapy?
  • What are all of the possible risks and side effects?

Surgery is not the right choice for everyone. Some people may benefit more from surgery than others. Side effects of surgery may include:

  • Pain
  • Bleeding and throat swelling
  • Orthodontia and a limited diet for several weeks
  • Overnight hospital stay

In some cases, the benefits may not be permanent and sleep apnea may return.

What are the types of surgical procedures for sleep disorders?

There are different types of surgery for sleep apnea and snoring. Surgery may be a multi-step process involving more than one procedure. You may need to continue using CPAP even when surgery successfully reduces the severity of sleep apnea. It is important to follow up regularly with your sleep doctor after surgery.

Surgical options include:

Uvulopalatopharyngoplasty (UPPP)

This procedure, and other types of soft palate surgery, targets the back of your mouth. It involves removing and repositioning excess tissue in the throat to make the airway wider. The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. It may be combined with surgeries that target other sites in the upper airway.

Upper airway stimulation therapy

Upper airway stimulation involves an outpatient procedure to implant a device that monitors your breathing while you sleep. The device stimulates the hypoglossal nerve, which controls your tongue’s movements, pushing it out of the way to keep the airway open.

To be eligible, patients must have moderate to severe sleep apnea that cannot tolerate CPAP or oral appliance. They also must be at least 22 years old and not significantly overweight. Patients will have to meet with a surgeon to see if this procedure is an option for them. Patients can expect to have a sleep study before and after the procedure.

Radiofrequency volumetric tissue reduction (RFVTR)

In this procedure, the surgeon uses a heated instrument to shrink and tighten the tissues in and around the throat. RFVTR can be used on the soft palate, tonsils and tongue.

Septoplasty and turbinate reduction

These surgical options open your nasal passage to improve air flow. Septoplasty straightens a bent or deviated nasal septum. This is the divider that separates the two sides of the nose. Turbinate reduction reduces or removes the curved structures that stick out from the side of the nose. They can be enlarged for a number of reasons, including allergies. Medicat