Alternatives to CPAP
Sleep Apnea Surgery: A Factual Overview of Options
Surgery can help selected adults with obstructive sleep apnea who cannot use CPAP, or can make CPAP easier to use. The AASM's 2021 guideline recommends clinicians discuss referral to a sleep surgeon with adults with a BMI under 40 who are intolerant of or unwilling to use PAP, and discuss bariatric surgery for those with a BMI of 35 or more.
Who should discuss surgery
The AASM 2021 surgical referral guideline makes a strong recommendation that clinicians discuss referral to a sleep surgeon with adults with obstructive sleep apnea and BMI under 40 who are intolerant of or unwilling to use PAP, and discuss referral to a bariatric surgeon with adults with obesity (class II or III, BMI 35 or more) who are intolerant of or unwilling to use PAP.
It also suggests discussing sleep surgery for adults with BMI under 40 who have poor PAP adherence due to pressure related side effects, and suggests PAP as initial therapy for those with a major anatomic airway abnormality, such as large tonsils.
Types of procedures
Nasal surgery (for a deviated septum or enlarged turbinates) mainly improves nasal breathing and can make a nasal CPAP mask easier to use. Tonsil and palate surgery, such as tonsillectomy and uvulopalatopharyngoplasty, removes or reshapes tissue in the throat.
Maxillomandibular advancement moves the upper and lower jaws forward to enlarge the airway. Hypoglossal nerve stimulation (Inspire) is an implanted device. Bariatric surgery treats obesity, which can lower sleep apnea severity.
Evaluation
A sleep surgeon will review your sleep study, examine your nose, throat and jaw, and may examine your airway during sedated sleep to see where it collapses. The right procedure depends on where and how your airway narrows.
Ask what results you can realistically expect, the recovery time, the risks, and whether you might still need CPAP afterward.
After surgery
A follow-up sleep test is the way to know whether surgery worked. Keep using CPAP until your clinician tells you otherwise.
Some people still need CPAP after surgery but find it easier to use, especially after nasal surgery.
Frequently asked questions
Is there surgery for sleep apnea?
Yes, several types, from nasal and throat surgery to jaw advancement, nerve stimulation and bariatric surgery. The right option depends on your anatomy, sleep study and health.
Who is a candidate for sleep apnea surgery?
The AASM recommends discussing sleep surgery with adults with BMI under 40 who cannot or will not use PAP, and bariatric surgery with those with BMI 35 or more who cannot or will not use PAP.
Will I still need CPAP after surgery?
Possibly. A follow-up sleep study shows whether you still need treatment, and some people use CPAP more comfortably afterward.
Does nasal surgery cure sleep apnea?
Usually not on its own. It mainly improves nasal breathing, which can make CPAP easier to tolerate.
Sources
Last reviewed October 11, 2026. How we research · Report an error