Snoring and sleep apnoea surgery in Barcelona

At a glance

Who it is for: Snorers and patients with mild or moderate apnoea, or who cannot tolerate CPAP.
Diagnosis: Sleep study and drug-induced sleep endoscopy (DISE), at the clinic or in theatre.
Techniques: Bipolar radiofrequency, laser, palate surgery and pharyngoplasty, tonsil, tongue-base and nasal surgery.
Anaesthesia: Local for some radiofrequency techniques; general for the rest.
Recovery: From a few days (radiofrequency) to two weeks (palate surgery).

Snoring is more than a nuisance

Snoring happens when air makes parts of the airway vibrate as they narrow during sleep: the soft palate, the uvula, the tonsils, the base of the tongue or the nose itself. For many people it is just a noise that disturbs their partner. For others it is a sign of obstructive sleep apnoea: the airway closes completely for seconds, sometimes for more than a minute, and breathing stops many times an hour.

Untreated sleep apnoea is linked to daytime tiredness, poor concentration, morning headaches, high blood pressure, cardiovascular problems and a higher risk of road accidents.

Warning signs

Loud snoring every night.
Pauses in breathing noticed by your partner, followed by a sudden snort.
Waking up choking or gasping.
Daytime sleepiness, even while driving.
Unrefreshing sleep despite enough hours in bed.

Diagnosis: where and how much the airway closes

Full ENT examination with endoscopy of the nose, pharynx and larynx.
Sleep study (polygraphy or polysomnography) to confirm whether there is apnoea and how severe it is.
Drug-induced sleep endoscopy (DISE): under controlled sedation, an endoscope shows which structures collapse during sleep. This is what allows the right technique to be chosen and avoids operations that will not work. It is done at the clinic or, in some cases, in theatre.

Surgical options

Surgery is tailored to the site of obstruction and often combines several steps in one operation:

Nose: septoplasty and turbinate reduction when nasal blockage forces mouth breathing.
Soft palate and uvula: bipolar radiofrequency or laser to stiffen a floppy palate, or pharyngoplasty techniques that reposition and tighten the tissues.
Tonsils: tonsillectomy or radiofrequency tonsillotomy when they are large.
Tongue base: bipolar radiofrequency reduction when it falls backwards during sleep.

For snorers without apnoea or with mild apnoea, bipolar radiofrequency and laser allow minimally invasive treatment, sometimes under local anaesthetic, with a recovery of a few days.

Recovery

It depends on the technique. After radiofrequency, throat discomfort usually lasts a few days. After palate or tonsil surgery, painful swallowing can last one to two weeks and a soft diet is advised. Some time later the sleep study is repeated to check the result.

Risks

Painful swallowing, bleeding, temporary changes to the voice or swallowing, and persistent snoring. We will explain the specific risks of the proposed technique and the reasonable outcome in your case.

Frequently asked questions

Can all snoring be treated with surgery?

Not all snoring needs surgery. First, sleep apnoea must be ruled out and the site of obstruction identified: nose, palate, tonsils or tongue base. With that diagnosis we decide whether surgery, a mandibular advancement device, CPAP or measures such as weight loss or positional therapy are the best option.

What is sleep endoscopy (DISE)?

It is an examination with a thin endoscope while you sleep under controlled sedation. It shows which structures vibrate or collapse during sleep and how much, which cannot be seen when you are awake. It is key to choosing the right surgery. We do it at the clinic or, in some cases, in theatre.

I have sleep apnoea and cannot tolerate CPAP. Can I have surgery?

This is one of the most common reasons to consider surgery. In some cases surgery replaces CPAP; in others, especially nasal surgery, it helps you tolerate CPAP better.

Is palate radiofrequency painful?

It is a minimally invasive technique that can be done under local anaesthetic. Throat discomfort usually lasts a few days and is managed with painkillers.

Is the result permanent?

It depends on the cause and on factors such as weight. At your consultation we will explain what result is reasonable to expect in your case and how to keep it.

You may also be interested in

Before surgery you receive the informed consent document of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC), which explains the technique, its alternatives and its risks.

Guidance written by the team of Dr. Carlos Magriñá, an ENT surgeon with more than 35 years of experience in Barcelona. Every case needs an individual medical assessment.

Snoring and obstructive sleep apnoea surgery