Continuous positive airway pressure (CPAP) may be the go-to treatment for sleep apnea, but many people struggle to use it every night. For those who cannot tolerate CPAP, new research finds that a combination of surgical techniques may bring relief.

The “multilevel” treatment includes removing the tonsils, repositioning the palate (roof of the mouth) and using radiofrequency to slightly reduce the size of the tongue. In combination, these procedures open up the airway and reduce breathing obstruction, the researchers said.

The study found that the multilevel surgery technique reduced the number of times people stopped breathing (apnea events) during sleep and improved daytime sleepiness. People also reported better quality of life after the treatment.

“Obstructive sleep apnea is common and many people cannot use the main treatments, like CPAP masks. Surgery is a valid option when an expert surgeon is involved, and it can improve outcomes,” said the study’s lead author, Dr. Stuart MacKay. He’s an honorary clinical professor of otolaryngology, head and neck surgery at University of Wollongong, in Australia.

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