What is sleep apnea?
Sleep apnea is a type of sleep disruption that can have serious health consequences. It causes your breathing to periodically stop while you’re sleeping. This is related to the relaxation of the muscles in your throat. When you stop breathing, your body usually wakes up, causing you to lose out on quality sleep.
Over time, sleep apnea can increase your risk of developing high blood pressure, metabolic issues, and other health problems, so it’s important to treat it. If nonsurgical treatments don’t help, you may need surgery.
What are the different procedures?
There are many surgical options for treating sleep apnea, depending on how severe your sleep apnea is and your overall health.
Radiofrequency volumetric tissue reduction
If you can’t wear a breathing device, such as a continuous positive airway pressure (CPAP) machine, your doctor might recommend radiofrequency volumetric tissue reduction (RFVTR). This procedure uses radiofrequency waves to shrink or remove tissues in the back of your throat, opening up your airway.
Keep in mind that this procedure is often used to treat snoring, though it may also help with sleep apnea.
According to the Cleveland Clinic, this is one of the most common surgeries for treating sleep apnea, but not necessarily the most effective. It involves removing extra tissue from the top of your throat and the back of your mouth. Like an RFVTR procedure, it’s usually only done if you can’t use a CPAP machine or other device, and tends to be used as a snoring treatment.
This procedure is also called jaw repositioning. It involves moving your jaw forward to create more space behind the tongue. This can open up your airway. A small 2016 study involving 16 participants found that maxillomandibular advancement reduced the severity of sleep apnea in all participants by more than 50%.
Anterior inferior mandibular osteotomy
This procedure divides your chin bone into two parts, allowing your tongue to move forward. This helps to open up your airway while stabilizing your jaw and mouth. This procedure has a shorter recovery time than many others, but it’s usually less effective. Your doctor might also suggest doing this procedure in conjunction with another type of surgery.
Genioglossus advancement involves slightly tightening the tendons in the front of your tongue. This can prevent your tongue from rolling back and interfering with your breathing. It’s usually done alongside one or more other procedures.
Midline glossectomy and base of tongue reduction
This type of surgery involves removing a portion of the back of your tongue. This makes your airway larger. According to the American Academy of Otolaryngology, studies show that this procedure has success rates of 60 percent or higher.
This procedure removes both your tonsils as well as tonsillar tissue near the back of your tongue. Your doctor might recommend this option to help open up the lower part of your throat for easier breathing.
Septoplasty and turbinate reduction
The nasal septum is a mix of bone and cartilage that separates your nostrils. If your nasal septum is bent, it can affect your breathing. Septoplasty involves straightening your nasal septum, which can help to straighten out your nasal cavities and make it easier to breath.
The curved bones along the walls of your nasal passage, called turbinates, can sometimes interfere with breathing. A turbinate reduction involves reducing the size of these bones to help open up your airway.
Hypoglossal nerve stimulator
This procedure involves attaching an electrode to the main nerve that controls your tongue, called the hypoglossal nerve. The electrode is connected to a device that’s similar to a pacemaker. When you stop breathing in your sleep, it stimulates your tongue muscles to prevent them from blocking your airway.
If your sleep apnea is caused by a blockage near the bottom of your tongue, your doctor might suggest a procedure called hyoid suspension. This involves moving the hyoid bone and its nearby muscles in your neck closer to the front of your neck to open up your airway.
Compared to other common sleep apnea surgeries, this option is more complex and often less effective. For example, one small study involving 29 participants found that it has a success rate of only 17 percent.
What are the risks of surgery for sleep apnea?
While all surgeries carry some risks, having sleep apnea can increase your risk of certain complications, especially when it comes to anesthesia. Many anesthesia medications relax your throat muscles, which can make sleep apnea worse during the procedure.
As a result, you’ll likely need extra support, such as endotracheal intubation, to help you breathe during the procedure. Your doctor might suggest you stay in the hospital a bit longer so they can monitor your breathing as you recover.
Other possible risks of surgery include:
- excessive bleeding
- deep vein thrombosis
- additional breathing problems
- urinary retention
- allergic reaction to anesthesia
Talk to your doctor
If you’re interested in surgery for sleep apnea, start by talking to your doctor about your symptoms and other treatments you’ve tried. According to the Mayo Clinic, it’s best to give other treatments a try for at least three months before considering surgery.
These other options include:
- a CPAP machine or similar device
- oxygen therapy
- using extra pillows to prop yourself up when you sleep
- sleeping on your side instead of your back
- an oral device, such as a mouth guard, designed for people with sleep apnea
- lifestyle changes, such as losing weight or quitting smoking
- treating any underlying heart or neuromuscular disorders that might be causing your sleep apnea
The bottom line
There are many surgical options for treating sleep apnea, depending on the underlying cause. Work with your doctor to determine which procedure will work best for your condition.