Snoring & Sleep Apnoea (OSA)
Sleep apnoea and obstructive sleep apnoea syndrome (OSA) can seriously affect your health and quality of life. In selected cases, surgery offers an effective and long-lasting solution.
Case Examples
Surgical Treatment of Snoring & Sleep Apnoea
Watch the videos below to learn more about the most common conditions related to snoring and sleep apnoea, and how they can be addressed through surgery.
What Is Sleep Apnoea and What Are the Consequences?
Obstructive sleep apnoea syndrome, or OSA, is a clinical condition characterised by frequent upper airway obstruction during sleep. These obstructions can be complete (apnoeas) or partial (hypopnoeas).
Several factors can increase the risk of developing OSA, including weight gain, smoking, habitual snoring, and skeletal abnormalities of the nose or face.
Each episode of obstruction lowers blood oxygen levels and raises carbon dioxide levels.
Patients are typically unaware of these events during the night, but experience the consequences throughout the day: excessive sleepiness, difficulty concentrating, cognitive decline, sexual dysfunction, irritability and changes in mood or personality.
Il rischio di incidenti stradali o sul lavoro in questi pazienti è da 4 a 8 volte superiore rispetto ad un gruppo di controllo. Inoltre, gravi possono essere le ripercussioni sul sistema cardiovascolare, con sensibile aumento del rischio di ipertensione, infarto, ictus.
Diagnosis is confirmed through a specific sleep study — polysomnography — which measures the number of apnoea episodes per hour. More than 30 apnoeas per hour indicates a severe form of the condition, at which point the risk of cardiovascular events is particularly elevated and treatment becomes essential.
How Is Sleep Apnoea Treated?
The management of OSA requires a multidisciplinary approach and may involve a combination of medical and surgical options, tailored to the severity of the condition and each patient’s individual characteristics. The main treatment options include:
- CPAP (Continuous Positive Airway Pressure) — a device worn during sleep that delivers a continuous flow of pressurised air through a facial mask, keeping the upper airway open throughout the night
- Mandibular advancement devices — intraoral appliances, similar in appearance to orthodontic devices, that reposition the lower jaw during sleep. These are typically effective in milder forms of the condition and may be considered when CPAP is not tolerated.
When Is Surgery the Right Option?
Surgery represents an important alternative when other treatments have proven insufficient or unsuitable.
Surgical options vary depending on the severity of the condition: In milder cases, procedures targeting the nose and palate may be appropriate (performed by an ENT surgeon), In more severe cases, surgery involving the jaw bones — specifically maxillomandibular advancement — is indicated (performed by an oral and maxillofacial surgeon).
Maxillomandibular advancement involves surgically moving the upper jaw (maxilla) and lower jaw (mandible) forward — in some cases the mandible alone — sometimes combined with a genioplasty (chin repositioning).
These procedures are closely related to those performed for dentofacial deformities (see orthognathic surgery) and carry very high success rates.
Would you like more information?
Frequently Asked Questions
Clear answers to the most common questions about when to see a maxillofacial surgeon, what sleep apnoea is, and what treatment options are available.
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If snoring is habitual or accompanied by unrefreshing sleep, the most appropriate investigation to determine whether OSA is present is a sleep study — either a full polysomnography (carried out in a sleep laboratory) or a home-based cardiorespiratory test, depending on specialist recommendation. These tests measure breathing patterns, oxygen levels and sleep quality, and allow clinicians to distinguish between simple snoring and OSA. Based on the results, the most appropriate management pathway can be determined — whether that involves addressing lifestyle risk factors, specific therapies, or a functional assessment of the upper airway anatomy.
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Sleep apnoea can improve significantly and, in some cases, resolve entirely — though this depends on the underlying cause and severity. In many cases, the clinical objective is to reduce the number of apnoea episodes, improve oxygenation and sleep quality, and decrease daytime sleepiness and associated health risks. Treatment options include lifestyle modifications (weight management, alcohol reduction, sleep position), CPAP therapy, mandibular advancement devices, and — in carefully selected cases — surgical intervention where a clear anatomical indication exists. The most effective approach is always based on a thorough diagnostic assessment and specialist evaluation.
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The only reliable way to confirm a diagnosis of OSA is through a sleep study — either a polysomnography or a home sleep test. This measures the number, duration and oxygen impact of apnoea episodes.
Symptoms that may suggest OSA include loud snoring, observed breathing pauses during sleep, waking suddenly short of breath, fragmented sleep, excessive daytime sleepiness, morning headaches and a dry mouth on waking. However, symptoms alone are not sufficient to establish a diagnosis — a formal sleep study is always required. -
OSA tends to worsen when the upper airway becomes more prone to collapsing during sleep. The most common contributing factors include excess weight, alcohol consumption in the evening, sedatives or certain medications that reduce muscle tone, sleeping on your back, persistent nasal congestion, smoking and sleep deprivation. Certain anatomical features may also play a role. Identifying and addressing these factors — alongside the appropriate treatment — is often decisive in reducing the severity of symptoms and the overall burden of OSA.
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