Sleep apnea is a serious sleep disorder in which breathing repeatedly stops and starts throughout the night, depriving the brain and body of oxygen. While it is often treated with continuous positive airway pressure (CPAP) therapy, many patients struggle with CPAP compliance or have anatomical factors that make non-surgical approaches insufficient. For those individuals, oral surgeons offer a range of surgical interventions that address the underlying structural causes of airway obstruction.
At Legacy Oral Surgery and Implants, Dr. Nancy Herbst and our team work with patients across New Jersey who are seeking solutions for sleep apnea that CPAP alone has not resolved. With more than 25 years of experience in oral and maxillofacial surgery, we evaluate each patient’s airway anatomy, medical history, and sleep study results to determine which surgical approach offers the best long-term outcome. If you are considering your options, we encourage you to contact us online to schedule a consultation.
How Sleep Apnea Affects Your Health
Obstructive sleep apnea (OSA) is the most common form of the disorder. It occurs when the soft tissues at the back of the throat, including the soft palate, uvula, tonsils, and tongue, collapse during sleep and partially or fully block the airway. Each obstruction causes a brief arousal from sleep, often without the person’s awareness, that can occur dozens or hundreds of times per night.
The health consequences extend well beyond daytime fatigue. Untreated OSA is associated with an increased risk of high blood pressure, irregular heart rhythms, stroke, type 2 diabetes, and chronic fatigue conditions. For patients who are unable to use CPAP consistently, surgical treatment represents a clinically meaningful path toward better sleep and reduced systemic risk. The right surgical option depends on the specific anatomical factors causing the obstruction.
Four Surgical Solutions Oral Surgeons Can Provide for Sleep Apnea
Oral and maxillofacial surgeons are uniquely trained to evaluate and treat the bones, soft tissues, and joints of the face, mouth, and jaw, which makes them well-positioned to address the structural causes of obstructive sleep apnea. The following four procedures represent the primary surgical options available for appropriate candidates.
Uvulopalatopharyngoplasty (UPPP)
Uvulopalatopharyngoplasty, commonly referred to as UPPP, is one of the most widely performed surgical procedures for obstructive sleep apnea. The procedure removes excess soft tissue from the throat, including part or all of the uvula, portions of the soft palate, and sometimes the tonsils if they have not already been removed. By widening the airway at the back of the throat, UPPP reduces the tissue available to collapse during sleep.
UPPP is typically performed under general anesthesia and requires a hospital stay. Recovery involves throat soreness and restricted diet for one to two weeks. The procedure is most effective for patients whose obstruction is primarily located at the level of the soft palate, and results are best when the airway anatomy and patient weight are favorable. Sleep study data collected before surgery helps predict which patients are likely to benefit most.
Genioglossus Advancement (GA)
Genioglossus advancement addresses a common contributor to airway obstruction: the tongue falling backward during sleep. The genioglossus is the large muscle at the base of the tongue that plays a key role in keeping the airway open. In genioglossus advancement surgery, the bony attachment of this muscle is repositioned forward, which creates forward tension on the tongue and prevents it from collapsing into the airway while the patient is lying down.
This procedure is often performed in combination with other surgeries rather than as a standalone intervention, since tongue-base obstruction frequently occurs alongside other levels of airway narrowing. Recovery is generally well tolerated, with most patients resuming normal activity within two weeks. For patients whose sleep studies show tongue-base obstruction as a significant factor, genioglossus advancement can meaningfully improve outcomes when combined with an appropriate airway treatment plan.
Maxillomandibular Advancement (MMA)
Maxillomandibular advancement is considered one of the most effective surgical treatments for obstructive sleep apnea, with success rates consistently reported in the range of 80 to 90 percent for appropriately selected patients. The procedure moves both the upper jaw (maxilla) and lower jaw (mandible) forward simultaneously, which physically expands the entire upper airway from the nasal passage down to the base of the tongue. Unlike procedures that target a single anatomical level, MMA addresses the full length of the airway.
MMA is a more extensive surgery than UPPP or genioglossus advancement and requires a longer recovery period of four to six weeks, during which the jaws are stabilized. It is typically recommended for patients with moderate to severe sleep apnea who have not had adequate results with less invasive approaches, or for those whose anatomy makes other procedures unlikely to succeed. A thorough imaging evaluation and consultation with your oral surgeon helps determine whether MMA is appropriate for your specific case.
Hyoid Suspension
The hyoid bone is a U-shaped structure in the neck that serves as an anchor point for the tongue and throat muscles. In some patients with sleep apnea, the position or mobility of the hyoid contributes to airway collapse at the base of the tongue and hypopharynx. Hyoid suspension surgery repositions the hyoid bone and attaches it more anteriorly to the mandible or thyroid cartilage, stabilizing the tongue base and reducing the tendency for the airway to collapse in that region.
Hyoid suspension is most often performed as a component of a multi-level surgical plan rather than as a sole procedure. When combined with genioglossus advancement or other airway surgeries, it can address collapse at multiple points simultaneously. As with all sleep apnea surgeries, candidacy is determined through detailed sleep study analysis, physical examination, and imaging to identify where obstruction is occurring.
How We Determine the Right Approach for You
No two cases of obstructive sleep apnea are anatomically identical, which means effective treatment requires a thorough evaluation before any surgical plan is developed. During your consultation at Legacy Oral Surgery and Implants, Dr. Herbst reviews your sleep study results, performs a detailed examination of your airway anatomy, and may obtain imaging to assess the jaw, soft tissue, and airway dimensions.
Many patients benefit most from a combination of procedures that address obstruction at multiple levels. Our goal is to develop a treatment plan that reflects the actual cause of your sleep apnea, your overall health, and your preferences, rather than applying a single approach to every patient. We also coordinate with your sleep medicine physician and primary care provider to ensure that any surgical intervention fits within your broader care plan.
Frequently Asked Questions About Sleep Apnea Surgery
Who is a candidate for sleep apnea surgery?
Surgical candidates typically include patients who have been diagnosed with obstructive sleep apnea through a formal sleep study and who have either failed CPAP therapy or are unable to tolerate it long-term. Candidates should also have specific anatomical factors contributing to their obstruction that a surgical procedure can correct. Age, overall health, body weight, and the location and severity of airway obstruction all influence which procedure is appropriate. A consultation with an oral and maxillofacial surgeon, combined with a review of your sleep study data and imaging, is the best way to determine whether surgery is right for you.
Does sleep apnea surgery cure the condition?
Surgical outcomes vary depending on the procedure, the patient’s anatomy, and whether obstruction occurs at one level or multiple levels of the airway. Maxillomandibular advancement has the highest documented success rates, with many patients achieving significant reductions in apnea events. Other procedures are highly effective for the right candidates but may be less predictive as standalone interventions. Most patients benefit from a follow-up sleep study after surgery to assess outcomes. Weight gain after surgery can also affect long-term results, so lifestyle factors remain important even after a successful procedure.
What is the recovery time for sleep apnea surgery?
Recovery varies by procedure. UPPP typically requires one to two weeks before returning to normal activity, with throat discomfort and soft food restrictions during that time. Genioglossus advancement and hyoid suspension generally have similar recovery windows. Maxillomandibular advancement is the most involved, with a recovery period of four to six weeks, during which jaw movement is limited. Your oral surgeon will provide specific post-operative instructions tailored to the procedure you have had, including dietary guidelines, activity restrictions, and follow-up appointment timing.
Can I have more than one sleep apnea procedure at the same time?
Yes. Multi-level surgery, in which two or more procedures are performed simultaneously, is common for patients whose obstruction occurs at more than one point in the airway. Combining procedures like UPPP with genioglossus advancement, or genioglossus advancement with hyoid suspension, allows the surgeon to address several areas of narrowing in a single operative session. Your surgeon will review your anatomy and sleep study results to determine whether a combined approach is appropriate and will discuss the implications for anesthesia, recovery, and expected outcomes.
How do I get started with a sleep apnea surgery consultation?
The first step is scheduling a consultation with an oral and maxillofacial surgeon who has experience evaluating and treating obstructive sleep apnea. Bring any existing sleep study results and a list of treatments you have already tried. During the consultation, your surgeon will review your records, examine your airway anatomy, and discuss which surgical options may be appropriate based on your specific case. If you do not yet have a formal sleep study, your surgeon can help coordinate a referral to a sleep medicine specialist.
