Skip to content

Snoring, sleep & breathing

Airway & Sleep Apnoea Surgery

Loud snoring, waking up exhausted, struggling with a CPAP mask, or a child who pauses their breathing at night. Here's how the cause is found and when surgery may be an option.

Illustrative image: CPAP mask and a knitted toy elephant on a folded blanket in a calm consulting roomIllustrative image

Surgical management of obstructive sleep apnoea is considered for patients who cannot tolerate CPAP therapy, following formal sleep study and airway assessment. Paediatric airway care is provided at Netcare Mulbarton Hospital, and complex adult airway cases at Netcare Milpark Hospital.

Obstructive sleep apnoea

Obstructive sleep apnoea occurs when the upper airway repeatedly narrows or collapses during sleep. Untreated moderate to severe sleep apnoea is associated with daytime sleepiness and increased cardiovascular risk.

Continuous positive airway pressure (CPAP) is the first-line treatment. Surgery is considered for patients who are unable to tolerate CPAP, or in whom a specific anatomical obstruction has been identified.

Establishing surgical candidacy

A formal sleep study (polysomnography or a validated home study) is required before any surgical decision. Drug-induced sleep endoscopy may be used to identify the level and pattern of airway collapse, which guides the choice of procedure.

Surgery is not suitable for every patient, and outcomes vary. Weight management and positional therapy are often part of the overall plan.

  • Formal sleep study confirming the diagnosis and severity
  • Documented CPAP trial and reasons for intolerance
  • Examination of the nose, palate, tongue base and larynx
  • Body mass index and relevant comorbidities

Paediatric airway

In children, enlarged tonsils and adenoids are the most common cause of obstructed breathing during sleep. Snoring with pauses in breathing, restless sleep and daytime behavioural changes warrant assessment. Paediatric airway care is provided at Netcare Mulbarton Hospital.

Treatments in this area

  • Uvulopalatopharyngoplasty (UPPP) and palatal surgery
  • Drug-induced sleep endoscopy (DISE)
  • Adenotonsillectomy
  • Laryngotracheal reconstruction
  • Tracheostomy

Your care team may include: ENT and airway surgery, Sleep medicine, Paediatric anaesthesia and paediatric ward (Netcare Mulbarton), Adult intensive care (Netcare Milpark).

For referring doctors

When to refer, and what to send

Send a secure referral

Referral criteria

  • Confirmed obstructive sleep apnoea with CPAP intolerance
  • Loud snoring with witnessed apnoeas in a child
  • Stridor or suspected subglottic or tracheal stenosis
  • Recurrent tonsillitis meeting accepted criteria for tonsillectomy

Helpful work-up before consultation

  • Sleep study report (polysomnography or home study)
  • CPAP compliance data where available
  • Flexible nasendoscopy findings, if performed
  • CT neck or airway imaging for suspected stenosis

Common questions

Things people often ask

Can't see your question here? The rooms are happy to help.

Contact the rooms
Is surgery an alternative to CPAP?

For selected patients who cannot tolerate CPAP, surgery may reduce airway obstruction. A sleep study and airway assessment are required first to determine whether surgery is appropriate and which procedure is most suitable.

My child snores and stops breathing at night. Where can they be assessed?

Paediatric airway assessment, including evaluation for adenotonsillectomy, is available at Dr Kana's rooms at Netcare Mulbarton Hospital, Suite 11, in Johannesburg South.

Travelling from outside South Africa?

Medically reviewed by Dr Nadir Kana, Otorhinolaryngology (ENT) and Head & Neck Surgery. Last reviewed .