Are any surgeries effective for obstructive sleep apnea

[Wesley_Clark]

I know that PAPs are the frontline treatment. There are also various mandible and tongue holding devices. Plus mouth exercises, sleep positions, weight loss, etc.

My understanding that as far as surgery though, the surgeries aren’t very effective in a consistent way. What is the evidence for or against that argument?

Thissays hyoid suspension doesn’t do much for OSA, but there are about a half dozen different surgeries for the condition.

[TreacherousCretin]

20-year CPAP user here.

I think there have been a few threads about this over the years, might be worth a search.
From what I’ve read and heard, including a first-hand report from a friend who underwent the procedure, the surgeries are seldom successful, and the recovery period is extremely painful.
My own experience is possibly relevant: Shortly before I was diagnosed with OSA, my ENT Doctor removed my uvula to alleviate my extremely loud snoring. It did reduce my snoring volume from “windows rattling” to “merely keeping everyone else awake.”
The recovery was a nightmare. Six days of the worst pain I’ve ever experienced, even with meds.

[akennett]

I don’t have any real scientific evidence, but I worked as an MA in a sleep clinic for several years and have some anecdotal evidence from that. For the most part, the adult patients we saw who had any form of surgery specifically for OSA fell into two groups – the larger of the groups showed no appreciable effect during follow-up testing and the smaller group showed a small reduction in severity. Of this latter group, it usually resulted only in a reduction of their prescribed CPAP pressure, not a cessation of use.

About the only adult surgery that we saw that had any real effect on OSA was bariatric surgery for those who needed it. Getting the pounds off can really help.

Surgery seemed to be a better bet for children, presumable because their apnea was more likely related to a structural defect, rather than caused by age and obesity.

[Wesley_Clark]

@akennett

About the only adult surgery that we saw that had any real effect on OSA was bariatric surgery for those who needed it. Getting the pounds off can really help.

It was my understanding that even bariatric surgery didn’t eliminate the need for CPAP.

Bariatric Surgery Does Not Resolve Obstructive Sleep Apnea

Who knows though.

[Qadgop_the_Mercotan]

Current medical consensus on surgery for obstructive sleep apnea, from UpToDate, a reputable website for medical professionals:

Upper airway surgery — There is no consensus regarding the role of surgery in patients with OSA of varying degrees of severity, nor have optimal screening or imaging procedures been established that accurately predict which patients are most likely to benefit from surgery. We generally consider surgical therapy when positive airway pressure or an oral appliance is declined or ineffective (after at least a three month trial of therapy).

Surgical treatment appears to be most effective in patients who have OSA due to a severe, surgically correctable, obstructing lesion of the upper airway. Examples of surgically correctable lesions that may obstruct the upper airway include tonsillar hypertrophy, adenoid hypertrophy, or craniofacial abnormalities.