The most common treatment for obstructive sleep apnea (OSA) is a continuous positive airway pressure (CPAP) machine. While this device is highly effective for many, research suggests that more than half of the people who try CPAP find it difficult to stick with in the long run. If you struggle to wear a CPAP machine at night, you might be wondering about other treatment options, like sleep apnea surgery.

Read on to learn how sleep apnea surgery works, the different procedures available, and how to determine if it’s the right next step for your health.

Determine if You Are a Candidate for Surgery

Sleep apnea causes your upper airway to become blocked during sleep, interrupting your breathing and preventing the deep rest your body needs to recharge. Untreated sleep apnea can increase your risk for serious complications, so if a CPAP machine doesn’t work for you, it’s important to find another effective treatment.

For most adults, surgery is considered a second-line treatment. It’s typically an option explored only after you have tried other treatments, such as a CPAP machine or oral appliance, without success.

Generally, your doctor will look at the following main factors to determine if surgery is the right path for you.

Finding a Fixable Problem

Your healthcare team needs to confirm that a specific part of your anatomy is causing the blockage that leads to sleep apnea symptoms. They will likely use a physical exam, imaging scans, or a sleep endoscopy to map your airway. Surgery is only recommended if there is a clear, physical obstruction that can be repaired.

Checking Your Overall Health

You need to be healthy enough to undergo anesthesia safely. If you live with heart or lung conditions, the risks of surgery might be higher than the benefits. Having a strong support system at home is also a key part of your recovery plan.

Pinpoint the Blockage

Because your throat muscles relax differently when you sleep, a standard exam while you’re awake might miss the real cause of the blockage. To see the full picture, specialists often use a test called drug-induced sleep endoscopy (DISE).

During this procedure, the doctor uses mild sedation to mimic natural sleep. They guide a small camera through your nose to see exactly which tissues are collapsing. This helps them choose the most effective treatment for you.

However, not every medical center offers this specific test. If DISE is not available, you will undergo a complete examination of your nose, mouth, and throat. These examinations may include measurement of airflow through the nose and procedures, such as nasal endoscopy and laryngoscopy, to view nasal structures.

If you and your physician decide surgery is the right option, you will undergo imaging scans to plan for the surgical procedure.

Match Procedures to Your Anatomy

Sleep apnea happens when the muscles in your nose, mouth, or throat relax and block your airway. Surgery focuses on the specific spot causing the trouble. The goal is to open up those tight spaces so you can breathe properly while you sleep. Below are several types of surgeries that your doctor might consider.

Clearing Your Nasal Passages

Nasal surgeries help open your airways to improve airflow. While they typically do not eliminate sleep apnea on their own, they play a key role in treatment. By clearing physical blockages, these procedures often make it more comfortable for you to use a CPAP machine or oral appliance.

Your doctor may recommend specific procedures to help you breathe easier.

• Septoplasty — This procedure straightens a crooked nasal septum to help air flow freely.
• Turbinate reduction — This procedure shrinks swollen tissue inside the nose to reduce congestion.

Doctors often perform these together to maximize airflow and clear the path for better breathing.

Opening the Upper Throat

Many procedures focus on the soft palate and throat tissues because these areas often relax and block your breathing during sleep. By targeting these spots, surgeons can create a wider path for air to flow freely.

The most common surgery for sleep apnea is uvulopalatopharyngoplasty (UPPP). UPPP surgery involves removing or reshaping excess tissue in the back of the throat, including the uvula. By trimming these areas, the surgeon clears obstructions that prevent deep breathing.

Doctors may also recommend removing the tonsils and adenoids. While this is the standard first step for children, it’s also very effective for adults with enlarged tonsils that crowd the airway.

Adjusting the Tongue and Lower Throat

Sometimes, the tongue or the epiglottis (the small flap in your throat) slides back and blocks your breathing. To fix this, doctors often perform a surgery called genioglossus advancement. This involves moving the anchor point of your main tongue muscle forward on the jaw. It tightens the muscle, keeping the tongue in place so your airway stays open during sleep.

Other options include:

• Reduction of tongue tissue volume
• Removal of the tonsils at the back of the tongue (called lingual tonsils)
• Stabilization of the hyoid bone at the base of the tongue
• Fixation of the tongue to the front of the jaw

Expanding the Major Airways

For severe sleep apnea that affects the entire airway, doctors may recommend a procedure called maxillomandibular advancement (MMA). In this surgery, the surgeon moves both the upper and lower jaws forward. This physically pulls the tongue and soft tissues forward as well, creating much more space for you to breathe.

When it comes to surgically opening the airway, MMA is one of the most effective options available. However, MMA is a complex operation with a longer recovery time, so it’s usually reserved for individuals who have not found relief with other treatments.

Exploring Other Options

Instead of reshaping the throat, some treatments focus on muscle control. Hypoglossal nerve stimulation — often called a pacemaker for the tongue — uses a small device implanted in the chest. It senses when you breathe and sends a gentle pulse to move your tongue forward. This keeps the airway open and is a popular option if you find it difficult to use a CPAP machine.

Your doctor might also consider how body weight affects your breathing. Weight loss surgeries, like gastric bypass, can reduce the amount of tissue in the neck area. This eases the physical pressure on your airway and helps you breathe easier while you sleep.

Weigh Key Considerations Before Surgery

Before you decide to move forward with surgery, it is important to balance the potential benefits against the risks. The following points can help you and your family make an informed choice.

• Set realistic expectations — Surgery is rarely a complete cure, and you may still need CPAP at lower pressures.
• Understand anesthesia risks — Sleep apnea increases the risk of complications from sedation, requiring specialized monitoring.
• Know the side effects — Common risks include dysphagia (swallowing difficulties) or changes in voice and taste.
• Plan your recovery — Some procedures require a hospital stay, a liquid diet for weeks, need for a caregiver, and time off work.
• Commit to follow-up care — You may need a follow-up sleep study to objectively measure the results.

Move Forward With Your Treatment

Deciding to have surgery for obstructive sleep apnea involves weighing your options carefully. These procedures can offer a new path when other treatments have not worked, but it helps to view surgery as one part of a broader health journey rather than an instant fix. Recovery times and outcomes vary, so patience and open communication with your medical team are essential.

Before your consultation, take a few practical steps today:

• Write down your top three concerns to discuss with your surgeon.
• Ask a friend or family member if they can help during recovery.
• Contact your insurance provider to verify coverage for specific procedures.

Scheduling a visit with a qualified sleep specialist is the best way to determine if a surgical approach fits your needs and long-term well-being.

Join the Conversation

On MySleepApneaTeam, people share their experiences with obstructive sleep apnea, get advice, and find support from others who understand.

Have you had surgery for sleep apnea? Let others know in the comments below.