Can Sleep Apnea Be Treated With Surgery?

Sleep apnea can be treated with surgical methods in some people. However, surgery is not suitable for every person with sleep apnea and is generally not planned without an initial assessment. The type and severity of sleep apnea, the location of airway narrowing, age, weight, accompanying conditions, and response to previous treatments are considered when making a surgical decision.

In obstructive sleep apnea, the main purpose of surgery is to correct the anatomical problem that causes the upper airway to narrow or close during sleep. Enlarged tonsils, significant nasal obstruction, a backward-positioned jaw, soft palate tissues, or the tongue base narrowing the airway may require a surgical assessment.

Surgery may reduce pauses in breathing and snoring in some people. However, one surgical method does not provide the same outcome for every patient, and complete elimination of sleep apnea cannot be guaranteed.

This content is intended for general information. The need for surgery and the procedure to be used should be determined according to sleep test results and a detailed medical assessment.

When Is Surgery Considered For Sleep Apnea?

Surgery is generally considered when a person has a correctable anatomical problem in the airway. Treatment is not selected solely according to the intensity of snoring. Breathing interruptions, oxygen drops during sleep, and the effect of the condition on daily life are assessed together.

Surgery may be considered when:

• The tonsils or adenoids are significantly enlarged.
• There is severe structural obstruction inside the nose.
• There is a significant deviation of the nasal septum.
• The soft palate and throat tissues narrow the airway.
• The upper or lower jaw is positioned backward.
• The tongue base blocks the airway during sleep.
• CPAP cannot be used despite appropriate adjustments.
• Oral appliances or positional treatment do not provide sufficient benefit.
• Clinically significant sleep apnea continues despite other treatments.

Difficulty adapting to CPAP does not automatically mean that surgery is required. The mask type, device pressure, humidifier use, and other problems affecting treatment adherence should first be assessed.

Which Operations May Be Used For Sleep Apnea?

The surgical procedure used for sleep apnea depends on the location and cause of airway narrowing. A procedure targeting one area may be sufficient for some people, while several anatomical regions may need to be assessed in others.

Surgical methods that may be considered include:

• Tonsil and adenoid surgery: May be performed when enlarged tonsils or adenoids narrow the airway.
• Nasal surgery: May be considered for a deviated nasal septum, enlarged nasal tissues, or significant nasal obstruction.
• Soft palate and throat surgery: May involve reshaping soft tissues that narrow the airway.
• Tongue-base procedures: May be performed in selected people whose tongue falls backward and blocks the airway.
• Jaw advancement surgery: Aims to widen the upper airway by moving the upper and lower jaws forward.
• Nerve stimulation treatments: Stimulation of the nerve controlling tongue movement may be considered in selected people who meet specific criteria.
• Bariatric surgery: May be considered when obesity contributes significantly to sleep apnea and the appropriate criteria are met.

Nasal surgery alone may not eliminate sleep apnea in every patient. However, it may make nasal breathing easier and help the person use a CPAP mask more comfortably.

The appropriate procedure is determined according to an ear, nose, and throat examination, sleep test results, and other imaging or endoscopic assessments when needed.

Does Sleep Apnea Surgery Completely Eliminate The Condition?

Sleep apnea surgery may significantly reduce breathing interruptions, oxygen drops, and snoring in some people. However, complete elimination of sleep apnea cannot be guaranteed. The outcome depends on the procedure, the location of narrowing, the severity of the condition, and the person’s general health.

A reduction in snoring after surgery may be a positive development. However, reduced snoring alone does not prove that sleep apnea has completely resolved. Breathing interruptions that are not noticed may continue during sleep.

Factors that may affect the surgical outcome include:

• The severity of sleep apnea before surgery
• Narrowing in more than one area of the airway
• The person’s weight and changes in weight
• Jaw and facial structure
• Reduced muscle tone with age
• Smoking and alcohol use
• Adherence to postoperative recommendations
• Accompanying heart, lung, or metabolic conditions

A person should not neglect follow-up assessments even when they feel more rested after surgery. A repeat sleep test may be required to assess the success of treatment.

Which Assessments Are Performed Before Surgery?

Before planning sleep apnea surgery, the presence and severity of the condition should be assessed objectively. Surgery should not be planned based only on snoring. Snoring and sleep apnea are not the same condition, and not every person who snores experiences pauses in breathing.

Preoperative assessments may include:

• Detailed review of symptoms experienced during sleep
• Information about snoring and witnessed pauses in breathing
• Assessment of daytime sleepiness
• Review of sleep test results
• Ear, nose, and throat examination
• Assessment of the nose, palate, tonsils, tongue base, and jaw structure
• Review of accompanying conditions and medication
• Assessment of heart and respiratory risks
• Endoscopic examination or imaging when needed

A sleep test helps determine the frequency of breathing interruptions and their effect on oxygen levels. However, it does not independently show the exact location of anatomical narrowing. Therefore, the results should be assessed together with the physical examination and other tests.

What Should Be Considered After Sleep Apnea Surgery?

Recovery after surgery varies according to the procedure. Nasal surgery and jaw advancement surgery do not have the same recovery period or precautions. Postoperative recommendations should therefore be provided individually by the surgeon.

The following may need to be considered after surgery:

• Using prescribed medication only at the recommended dose and for the specified duration
• Attending follow-up appointments
• Following instructions for care of the surgical area
• Avoiding strenuous physical activity for the recommended period
• Avoiding smoking and alcohol
• Continuing lifestyle habits that support weight control
• Following recommendations about sleep position
• Following the physician’s plan regarding CPAP use
• Observing changes in snoring and daytime sleepiness
• Having a follow-up sleep test when required

People who use CPAP should not independently stop using the device because they have undergone surgery. Whether CPAP is still needed should be determined through a follow-up sleep test and medical assessment.

Severe bleeding, rapidly increasing swelling, significant shortness of breath, chest pain, high fever, or altered consciousness after surgery requires urgent medical assessment.

Plan Your Home Sleep Test With Happ Health

Before surgery is considered for sleep apnea, the presence and possible severity of the condition should be investigated. With the Happ Health Home Sleep Test service, offered with the assurance of Medical Park and Liv Hospital, breathing events and oxygen changes during sleep can be recorded in your own sleep environment.

A Home Sleep Test does not independently establish the need for surgery or identify the exact location of airway narrowing. A physician should evaluate the findings together with an ear, nose, and throat examination, symptoms, and medical history.

With Happ Health’s Health Everywhere, For Everyone, Always. approach, you can conveniently plan the sleep testing stage before a surgical assessment.