Although it is growing in popularity, researchers have concluded that upper airway surgery should not be the first-line treatment for obstructive sleep apnea. Instead, the surgery, known as uvulopalatopharyngoplasty, a procedure that removes excess tissue in the throat to make the airway wider, should be confined to controlled clinical trials.

Several recent meta-analyses and literature reviews found inconsistent benefits and high rates of adverse effects from upper airway surgery, said Adam G. Elshaug, PhD, of the University of Adelaide in Adelaide, Australia, and colleagues in the January 5 issue of BMJ (British Medical Journal)

Continuous positive airway pressure (CPAP), along with weight and alcohol management, should be the preferred first-line treatment. Mandibular advancement devices should be a second-line choice, the researchers said.

Five published systematic reviews were analyzed, including two the researchers had conducted themselves. None of the reviews found unalloyed benefit for uvulopalatopharyngoplasty.