Sleep Apnea & Snoring Surgery in Delhi

Sleep Apnoea Surgery

Sleep apnoea surgery refers to surgical procedures performed to improve airflow during sleep by removing, repositioning, or reshaping tissues that cause airway obstruction.

These surgeries are typically considered for patients with moderate to severe Obstructive Sleep Apnoea (OSA) who:

Cannot tolerate or refuse PAP therapy (CPAP/BiPAP)
Have anatomical blockages contributing to OSA (like enlarged tonsils, deviated septum, etc.)

Causes

Enlarged tonsils or adenoids (especially in children).
Deviated nasal septum or nasal polyps.
Long or thick soft palate or uvula.
Enlarged tongue or bulky tissues at the back of the throat.
Collapsing pharyngeal walls.

Jaw misalignment or small lower jaw (retrognathia).

Symptoms

Loud snoring with choking/gasping episodes during the sleep.
Persistent daytime sleepiness despite using PAP therapy.
Intolerance or non-compliance to PAP devices.
Breathing pauses during sleep (witnessed apnoea).
Sleep-disordered breathing with anatomical abnormalities.
Poor sleep quality and morning headaches.

Diagnosis

Surgical evaluation includes:

Level 1 Sleep Study (Polysomnography) to confirm the severity of OSA.
Flexible Nasal Endoscopy / Sleep Endoscopy (DISE) to identify the site(s) of obstruction.
CT scan / MRI (if structural evaluation needed).
Cephalometric X-rays (for jaw alignment).
Review of CPAP compliance data and patient discomfort reports.

Treatment

UPPP (Uvulopalatopharyngoplasty)

It helps to remove excess tissue from soft palate and uvula.
Most common soft tissue surgery for OSA.
May reduce snoring and apnea severity.

Tonsillectomy & Adenoidectomy

It includes the removal of enlarged tonsils/adenoids.
It is highly effective in children with OSA.
This also helps in adults with large tonsils.

Septoplasty / Turbinate Reduction

It straightens the nasal septum and shrinks nasal turbinate’s.
It improves nasal airflow and PAP tolerance.

Genioglossus Advancement / Tongue Base Reduction

This pulls forward the tongue muscle or reduces tongue size.
It prevents the tongue from blocking the airway during sleep.

Maxillomandibular Advancement (MMA)

This moves the upper and lower jaw forward.
It expands the airway space significantly.
It is often recommended in severe OSA or failed previous surgeries.

Hypoglossal Nerve Stimulation (Inspire Device)

A small device implanted under the skin.
Stimulates the tongue muscle during sleep to prevent blockage.
This is for the patients who are intolerant to CPAP with moderate-severe OSA.

Tracheostomy (Rare & Last-Resort)

In this it creates a hole in the windpipe for breathing.
Reserved for life-threatening OSA or those who fail all other treatments.

Frequently Asked Questions (FAQs)

1. Is surgery a cure for sleep apnoea?

No, not always. While the surgery can significantly reduce the symptoms or severity, but complete cure is not guaranteed. It may reduce or eliminate the need for PAP therapy in some cases.

2. What if I still need CPAP after surgery?

Yes, that’s possible. Surgery often improves CPAP effectiveness and comfort by reducing resistance. You may require lower pressures or more tolerable mask interfaces post-surgery.

3. Are these surgeries safe?

Yes, but like any surgery, they carry risks such as bleeding, infection, pain, voice change, or airway swelling. Choosing an experienced ENT or sleep surgeon reduces complications.

4. Can children also undergo sleep apnoea surgery?

Yes. In fact, tonsillectomy and adenoidectomy are the first-line treatment for most children with OSA. It usually leads to complete resolution of symptoms.