Does Sleep Apnea Surgery Actually Help? Answering Your Questions & More

While continuous positive airway pressure (CPAP) is typically the go-to treatment option healthcare professionals prescribe, some patients may opt for surgical procedures instead. Surgery is often reserved for individuals who have tried non-surgical treatments—like CPAP or oral appliance therapy—but have not found success in doing so. Surgery may be an option for cases ranging from mild to severe OSA, so to provide more information on this topic, we’re answering the most commonly asked questions about sleep apnea surgery with the help of Aeroflow Sleep Science Advisor, Dr. Carleara Weiss.

If you have obstructive sleep apnea (OSA,) it is critical that you seek treatment. If left untreated, OSA can lead to serious health problems, beyond just daytime sleepiness; such as heart failure, high blood pressure, and stroke. So, what are the different types of sleep apnea surgery?

Well, there is not just one surgical option for sleep apnea; in fact, there are several different types of sleep apnea surgery. We’ve broken down the most popular options by surgery type below:

Palate Surgery:

• Uvulopalatopharyngoplasty (UPPP): This is a surgery that helps open your airways by removing or reconstructing the soft tissue in the back of the throat. Your surgeon may remove or reconstruct your uvula, tonsils, and soft palate when performing this surgery.
• Pharyngoplasty: This is another surgery focused on the throat area. This surgery helps widen the airway by reconstructing the soft palate and area around it, or the pharynx.

Tongue Surgery:

• Genioglossus Advancement: This is a surgical procedure where the lower jaw and the tongue muscle attached to it are repositioned and moved forward to make the tongue firmer and prevent airway obstruction.
• Glossectomy: This is a tongue reduction procedure, in which all or part of the tongue is removed to prevent airway blockages.
• Lingual Tonsillectomy: The lingual tonsils can be found on the back of the tongue, and sometimes they can become enlarged in adults. As a result, these can be removed to improve airflow while sleeping.
• Hyoid Suspension: This procedure moves the hyoid bone, or the small bone that supports the tongue, forward in the neck. This surgery can help increase oxygen flow and reduce snoring.

Nasal Surgery:

• Septoplasty: A deviated septum can cause nasal obstructions, making it difficult to breathe while sleeping. A septoplasty is a surgery where the septum is repositioned to reduce obstructions.
• Turbinate Reduction: Turbinates are small structures inside the nasal cavity that humidify and filter the air we inhale. Sometimes these structures can swell and cause blockages. A turbinate reduction is a surgical procedure that helps shrink turbinates and restore normal airflow.
• Nasal Valve Surgery: This surgery helps increase the size of the nasal passage, making it easier to breathe while sleeping.
• Endoscopic Sinus Surgery: Inflammation of the sinuses can contribute to OSA, making it difficult to breathe while sleeping. During this surgery, a surgeon inserts an endoscope into the nasal cavity to view and clear blockages.

Other Surgical Treatments:

• Bariatric Surgery: Obesity has the potential to worsen OSA symptoms. Bariatric surgery is a weight loss surgery, which may be beneficial for patients who are struggling with both obesity and obstructive sleep apnea.
• Hypoglossal Nerve Stimulation (HGNS): This is an outpatient procedure where a small device is implanted into the upper airway. This small device delivers a mild electric pulse to stimulate the nerve that controls the tongue muscles. There are now a few different HGNS devices available; you may hear them referred to as “Inspire” after the first FDA-approved implant.
• Tracheostomy: This surgery is typically reserved for individuals who have not had successful treatment with other treatment or surgery alternatives. During this procedure, the surgeon will make a permanent opening in the neck to the windpipe to increase airflow.

The success rate for sleep apnea surgery can vary. While these procedures may help reduce sleep apnea symptoms, they may not serve as a “cure” for your sleep apnea. For example, a 2020 study found that the most common sleep apnea surgery, uvulopalatopharyngoplasty, offers an 80.6% success rate for patients who have a “Stage I” palate size. Meanwhile, patients with other palate sizes typically do not see as high of a success rate; in fact, patients with “Stage 2” palette sizes report only a 37.9% success rate.

There are risks and side effects for every surgery. It’s best to consult your doctor and ask about the risks and side effects of the particular surgery you opt for. In addition to risks, it is a good idea to ask about recovery time, as many surgeries will require down time for you to heal and recover.

However, while we’re on the topic, it’s important to include that any procedure that uses general anesthesia can be dangerous for individuals with sleep apnea. This is because anesthesia can slow breathing, make it difficult to regain consciousness, and/or breathe normally after surgery. Aeroflow Sleep recommends speaking to your doctor to get more information on your potential risks.

It’s important to include that some individuals may experience symptom relief after a sleep apnea surgical procedure, but some may not. Most of the time, these procedures do not provide a perfect cure. Many patients will have to continue using other therapy options after a surgical procedure; including CPAP.

The bottom line is this, if you think you have a sleep disorder, it is important to first consult with a sleep medicine professional. Your doctor will likely recommend a sleep study to determine if you have a sleep disorder or not. If you’re diagnosed with sleep apnea, Aeroflow Sleep can help you get the CPAP supplies you need through insurance. Start by filling out our online qualify form to check your eligibility today!

References

Aalia Adil, Eelam, and Johnathan D McGinn. “Uvulopalatopharyngoplasty.” Edited by Arlen D Meyers, Medscape, Medscape, 9 Dec. 2020, emedicine.medscape.com/article/1942134-overview. 

“Pharyngoplasty.” Cleveland Clinic, Cleveland Clinic, 6 June 2023, my.clevelandclinic.org/health/treatments/21041-pharyngoplasty. 

Shargorodsky, Josef. “Uvulopalatopharyngoplasty (UPPP).” MedlinePlus, U.S. National Library of Medicine, 4 June 2023, medlineplus.gov/ency/article/007663.htm. 

“Sleep Apnea.” American Society of Anesthesiologists, American Society of Anesthesiologists, www.asahq.org/madeforthismoment/preparing-for-surgery/risks/sleep-apnea/. Accessed 28 June 2024.