Snoring surgery: procedures, side effects, recovery and who it helps

Snoring surgery covers a range of procedures, from quick treatments that stiffen the soft palate to operations that remove throat tissue or straighten the inside of the nose. Some people get real relief, but the evidence is thin, side effects range from mild to significant, and snoring can come back. Here's what each option involves, so you can have a better conversation with a surgeon.

What is snoring surgery?

Snoring surgery is any procedure that changes the tissues of the nose, soft palate or throat to reduce vibration or open the airway. The NHS says surgery is sometimes used for snoring when other treatments don't help, but it isn't widely available on the NHS, doesn't always work, and snoring can come back afterward.

Most snoring surgery targets one of two areas. The soft palate and uvula, at the back of the roof of the mouth, can flutter as air passes. The nose can be narrowed by a bent septum or swollen turbinates, which makes breathing harder. A 2019 German guideline on snoring in adults, written by several medical societies, says less invasive procedures should be preferred. It doesn't recommend invasive surgery outside the nose and soft palate for snoring alone.

Does snoring surgery work?

Snoring surgery works for some people, at least for a while, but the research is limited. The German guideline rates the overall level of evidence as low, because most studies involved small groups of patients followed for a short time. Results also tend to fade, which is why surgeons talk about long-term success rather than a cure.

Some procedures have randomized trials behind them and others don't. The guideline says reliable clinical studies on palate surgery exist only for UPPP and related palate operations, radiofrequency treatment and soft-palate implants. For nasal surgery, the evidence comes from case series rather than randomized trials.

What are the main types of snoring surgery?

The main types of snoring surgery are radiofrequency treatment of the soft palate, soft-palate implants, uvulopalatopharyngoplasty (UPPP), and nasal surgery such as septoplasty and turbinate reduction. They differ a lot in how invasive they are and how long recovery takes.

Radiofrequency treatment of the soft palate

Radiofrequency treatment aims to stiffen the soft palate so it vibrates less. NICE, which advises the NHS in England, describes it as usually done in outpatients under local anesthetic. A probe makes a series of shallow punctures in the palate and delivers radiofrequency energy to scar and tighten it. It is often repeated two or three times, several weeks apart.

In a randomized trial of 23 people summarized by NICE, bed partners' snoring scores fell from 8 to 5 out of 10 with radiofrequency, compared with 8.4 to 8.0 after a sham procedure. Only 2 of the 12 treated patients got below 3, the trial's mark of success. In one long-term case series, 25% of patients were satisfied three to four years later, and 28% had needed further treatment.

NICE concludes there are no major safety concerns and that short-term evidence is adequate, but that the long-term effect is uncertain. It says patients should be told about that uncertainty and the possible need for more procedures. The German guideline gives radiofrequency a grade A recommendation when palate surgery is chosen, and says pain afterward is low compared with other palate procedures.

Soft-palate implants

Soft-palate implants are small inserts placed into the muscle of the soft palate under local anesthetic, usually two or three at a time. NICE explains that the aim is to stiffen the palate over the following weeks as scar tissue forms around them.

In one small randomized trial, bed partners' snoring scores fell from 7.7 to 4.7 out of 10 at 90 days with standard implants. Case series found similar drops that partly held at one year. NICE found no major safety concerns but says the evidence comes only from small case series, so the procedure should only be used in research. Partial extrusion, where an implant starts working its way out, was reported in 4% to 25% of patients across case series.

Uvulopalatopharyngoplasty (UPPP)

UPPP is an operation that removes soft tissue at the back of the throat. MedlinePlus says it takes out all or part of the uvula, parts of the soft palate and the tissue at the sides of the throat, plus the tonsils and adenoids if they're still there. It's done for mild sleep apnea and sometimes for severe snoring.

UPPP is the most demanding option. MedlinePlus says it usually needs an overnight hospital stay, the throat can be very sore for several weeks, and full recovery takes 2 or 3 weeks with soft foods for the first two. It also says the surgery doesn't work for everyone and that insurance may not cover it if you don't have sleep apnea. The German guideline says UPPP should only be chosen on strict criteria because of its higher rate of complications.

Nasal surgery: septoplasty and turbinate reduction

Nasal surgery for snoring opens the nose so air flows more easily. Septoplasty straightens a bent septum, the wall between the nostrils, and MedlinePlus lists easing snoring caused by a nasal blockage as one reason to have it. Turbinate reduction shrinks the swollen tissue on the inside walls of the nose. If you think this applies to you, our guides to deviated septum symptoms and turbinate hypertrophy explain the signs.

The German guideline found that improving nasal airflow led to people rating their snoring as quieter, but septoplasty alone didn't change snoring when it was measured objectively. It recommends offering nasal surgery to snorers who also have trouble breathing through the nose. For snorers whose nose feels fine, it says there isn't enough evidence to make any statement. Our guide to nose surgery for breathing covers these operations in more detail.

How do the procedures compare?

What are the side effects of snoring surgery?

The side effects of snoring surgery depend on the procedure, from mild soreness after palate radiofrequency to weeks of throat pain after UPPP. The American Academy of Sleep Medicine lists pain, bleeding, throat swelling and, for some operations, a limited diet for several weeks and an overnight hospital stay. It adds that the benefits may not be permanent.

For radiofrequency, NICE's safety review reported bleeding in 2 of 218 patients, infection of the palate in 6 of 218, airway swelling needing steroids in 2 of 40, and mild to moderate erosion of the lining in 10 of 23. Specialist advisers also mentioned anecdotal reports of a hole in the palate.

For UPPP, MedlinePlus lists damage to the throat and palate muscles, mucus in the throat, speech changes, dehydration and bleeding. Some people have trouble stopping liquids from coming up through the nose when they drink, which MedlinePlus says is usually temporary.

For septoplasty, MedlinePlus lists the blockage returning, scarring, a hole in the septum, changes in skin sensation or smell, and changes in how the nose looks. For turbinate surgery, it lists crusting, a hole in the septum, changes in smell and the blockage returning.

What happens before and after snoring surgery?

Before snoring surgery, you'll be assessed to find where the snoring comes from and to rule out sleep apnea. After surgery, recovery ranges from a few days to a few weeks, and you'll be judging the result over months. For snoring, the before-and-after that matters most is how you and your partner rate the noise.

Before. The German guideline says the assessment starts with your history and an exam of the nose and throat. It recommends a sleep study for anyone who wants snoring treated, anyone suspected of another sleep breathing disorder and anyone with relevant heart or blood vessel conditions. The guideline adds that some surgeons use drug-induced sleep endoscopy, a look at the airway with a camera while you're sedated, to find where it vibrates. NICE stresses that snoring can come from several levels of the airway, and that palate radiofrequency should only be used when the palate has been shown to be the cause and sleep apnea has been excluded.

It helps to record your snoring before surgery and to ask your partner to rate it, so you have something to compare against.

After. For UPPP, MedlinePlus describes liquid pain medicine, salt-water mouth rinses for 7 to 10 days, soft foods for two weeks and no heavy lifting for two weeks. After septoplasty, it says packing usually comes out within 24 to 36 hours, the nose may drain or bleed a little for 2 to 5 days, and most people go back to work after a week. After turbinate surgery, it says you'll feel blocked until swelling settles and full healing can take up to 2 months.

The result can change over time. The German guideline describes snoring getting louder again about 1.5 years after one combined palate procedure, and other groups saw similar patterns. NICE describes repeat treatment as a real possibility.

Who is a good candidate for snoring surgery?

A good candidate for snoring surgery is an adult with a clear, reachable cause, such as a floppy soft palate or a blocked nose, who has had sleep apnea ruled out and has already tried simpler steps. The German guideline says the choice and success of any procedure depend heavily on your anatomy and body mass index.

Simpler steps come first for most people. MedlinePlus suggests seeing whether weight loss helps before UPPP and thinking about how much treating the snoring matters to you. The NHS lists losing weight, sleeping on your side, not smoking and cutting back on alcohol, and matches each cause of snoring to a non-surgical treatment. Our guides on how to stop snoring and anti-snoring mouthpieces cover those options.

If your snoring comes with gasping, choking, breathing pauses or daytime sleepiness, see a doctor about sleep apnea before thinking about snoring surgery. The AASM says surgery can be part of sleep apnea treatment for people who can't tolerate CPAP, but that UPPP alone is unlikely to cure moderate to severe sleep apnea. Our overview of sleep apnea treatment options explains the alternatives, and snoring vs. sleep apnea covers the warning signs.

What should you ask a surgeon?

Ask a surgeon what success rate to expect, how long recovery takes and why surgery suits you better than a device. The AASM suggests asking about the success rate, recovery time, time off work or school, how the procedure will change your snoring, why it's better for you than CPAP or an oral appliance, and all the possible risks and side effects.

It's also worth asking where your snoring comes from and how the surgeon found out, whether you'll have a sleep study before and after, and what happens if the snoring returns. Our list of questions to ask your doctor about snoring can help you prepare. This article is general information, not medical advice.

Read next

• Nose surgery for breathing: options, recovery and results
• Turbinate hypertrophy: causes, symptoms and treatment
• Sleep apnea treatment options

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.