Can Sleep Apnea and Snoring Be Improved with Double Jaw Surgery and Genioplasty?

  

Understanding the Relationship Between Jaw Structure and Airway Space Through Recent Research

Hello, I'm Dr. Chaeyeon Lee of EU Oral and Maxillofacial Surgery.

“My snoring is really bad. Would double jaw surgery help?”

“My jaw is narrow and I have a recessed chin. Could this be related to sleep apnea?”

“I'm preparing for double jaw surgery, and I'm wondering if my snoring might improve as well.”

Many people have heard somewhere that the position and size of the jaw bones are related to airway space. It is true that corrective jaw surgery is sometimes used to improve sleep apnea or snoring. However, this does not apply equally to everyone, and an individual assessment based on thorough examination must come first.

Today, let's go step by step through how jaw structure, the airway, and surgical approaches relate to one another.

Could This Apply to Me?

Before we get into the details, please check whether any of the following apply to you.

✔       People who sleep next to you often say your snoring is loud

✔       When you look in the mirror, your lower jaw appears set back (a recessed chin), or your side profile looks flat

✔       You don't feel refreshed after sleeping and are unusually drowsy during the day

✔       You frequently wake up with a dry mouth or a headache

✔       You've been told that you choke or gasp while sleeping

If two or more of these apply to you, your jaw structure may be contributing to your snoring or sleep apnea. The reasons are explained below.

Why Are Jaw Structure and the Airway Connected?

Sleep apnea is a condition in which the upper airway at the back of the throat repeatedly narrows or becomes blocked during sleep, causing breathing to become shallow or stop. Snoring, likewise, is the sound produced when air passes through a narrowed upper airway and causes the surrounding tissues to vibrate. Multiple studies have consistently suggested that the shape of this upper airway space is influenced by the jaw bones, particularly the position and size of the lower jaw.

When the lower jaw is positioned further back than normal or is small in size, the tongue, which is attached to it, is naturally pushed backward as well, which can narrow the airway space behind the base of the tongue. In one study, researchers measured the posterior width of the upper jaw (maxilla) in patients with moderate to severe sleep apnea and found that the narrower this width, the smaller both the minimum cross-sectional area and the total volume of the airway tended to be. In addition, a narrower width was associated with a greater drop in oxygen saturation during sleep (measured by the oxygen desaturation index, ODI).

Another study using CBCT divided the upper airway into four regions for analysis: behind the nose (nasopharynx), behind the soft palate (velopharynx), behind the base of the tongue (oropharynx), and around the epiglottis (hypopharynx). The results showed that the narrower the minimum cross-sectional area of the nasopharynx, the higher the apnea-hypopnea index.

*Apnea-Hypopnea Index (AHI): the number of apnea and hypopnea events per hour

The volume of the tongue itself is also a noteworthy factor. One study observed that tongue volume tended to increase with higher body mass index (BMI). Interestingly, tongue volume was more closely related to the lowest oxygen saturation during sleep than to the AHI itself. In other words, a larger tongue may play a greater role in how far oxygen levels drop when apnea occurs, rather than in how often apnea occurs.

That said, not all studies agree that “smaller airway volume means more severe apnea.” One study that analyzed the correlation between pharyngeal volume on cone-beam CT and AHI in 29 patients found no clear correlation between pharyngeal volume and AHI after controlling for BMI, age, and sex. Rather, this study concluded that it is difficult to predict the severity of sleep apnea from a single measure such as upper airway volume, and that multiple factors must be evaluated together. This is consistent with the findings of the fluid dynamics research described later.

Another study examining the relationship between sleep apnea symptoms and airway space measured upper airway length, volume, and width using CBCT images taken at dental clinics, and compared these with symptoms and comorbidities such as snoring, daytime sleepiness, and hypertension. The results showed that a longer airway and a smaller average volume were associated with snoring, and that patients with hypertension tended to have longer airways with smaller volume and width.

So How Are Double Jaw Surgery and Genioplasty Used?

When jaw structure is identified as the main cause of airway narrowing, maxillomandibular advancement (MMA), in which both the upper and lower jaws are moved forward together, may be considered as a treatment option. Broadly speaking, this surgery uses the same principle of skeletal repositioning as double jaw surgery, and is intended to enlarge the space around the tongue and soft palate as the jaw bones are advanced.

Of course, the degree of improvement after surgery can vary depending on the patient's preoperative condition and BMI. Rather than assuming that “double jaw surgery will always improve snoring,” it is important to carefully evaluate each individual's skeletal structure and airway condition before planning the direction and amount of movement in surgery.

Recently, approaches have also been introduced that go beyond simply moving the jaws forward and additionally rotate the jaw bones counterclockwise. By adjusting the angle of the occlusal plane (the surface where the teeth meet), this method aims to keep the change in facial appearance relatively small while maintaining the airway-widening effect. It reflects a recent trend of considering both facial aesthetics and functional improvement together.

 

Through genioplasty, advancing the area where the genioglossus muscle (the muscle that pulls the tongue forward) is attached can widen the space behind the base of the tongue, which can help improve sleep apnea.

How Consultation and Examination Proceed

To determine whether sleep apnea or snoring is caused by jaw structure, a thorough examination process is needed that differs from a cosmetic consultation. A polysomnography (sleep study) is used to objectively confirm the actual apnea-hypopnea index and changes in oxygen saturation, and imaging such as CBCT is used to examine the structure of the jaw bones and the airway together.

During this process, the approach may differ depending on whether the narrowed part of the airway is behind the nose or near the base of the tongue, and we also check whether other causes, such as rhinitis or enlarged tonsils, are present in addition to jaw structure.

Conclusion

In cases where jaw structure narrows the airway and leads to snoring or sleep apnea, there are reported cases in which symptoms improved after skeletal repositioning through double jaw surgery or genioplasty. Many patients who are considering double jaw surgery for cosmetic reasons ask, “Could my snoring improve too?” Given the connection between jaw bones and airway space, it is something that can reasonably be hoped for.

Of course, the degree of improvement may vary from patient to patient depending on skeletal structure, body weight, and the condition of the tongue and soft tissues. However, this is not something to worry about in advance; it is simply a matter of confirming the right direction for you through a thorough examination.

If you are concerned about snoring or sleep apnea, please don't feel pressured. We recommend that you first visit us for a polysomnography and a detailed airway examination. A consultation based on the test results may give you a clearer answer than you expect.

Frequently Asked Questions

Q. Can double jaw surgery help if I snore?

If the cause of your snoring lies in your jaw structure, improvement may be expected by widening the airway space through double jaw surgery. Since the exact cause must be confirmed through a thorough examination, if snoring is a concern for you, we recommend visiting us first for an examination to check whether it is related to your jaw structure.

Q. If I have double jaw surgery for cosmetic reasons, will my snoring also improve?

If the surgery moves the jaw forward, the airway space may widen as well, so improvement in snoring may also be expected. However, the degree may vary depending on your individual skeletal structure and soft tissue condition, so if you are also hoping to improve snoring, please mention this during your consultation. We can take it into account when planning your surgery.

Q. Can genioplasty also help improve snoring?

Genioplasty that secures space behind the base of the tongue, such as genioglossus advancement, can be used to improve the airway. Because this approach differs from commonly known cosmetic chin surgery, if improving snoring is your goal, please make this clear during your consultation so it can be reflected in your surgical plan.

Q. Can sleep apnea also be improved with surgery?

After evaluating the site of airway narrowing and the jaw structure together through polysomnography and CBCT imaging, if jaw structure is confirmed to be the main cause, improvement through surgical treatment may be expected.

References

[1] Ciavarella D, et al. Airway Analysis and Morphometric Assessment of Dental Arches in Obstructive Sleep Apnea Patients. J Clin Med. 2025;14:296.

[2] Jessadapornchai T, et al. 3D analysis of upper airway morphology related to obstructive sleep apnea severity. J World Fed Orthod. 2024;13:175-180.

[3] Ahn SH, et al. Tongue Volume Influences Lowest Oxygen Saturation but Not Apnea-Hypopnea Index in Obstructive Sleep Apnea. PLoS ONE. 2015;10(8):e0135796.

[4] Lin S, et al. Upper Airway Flow Dynamics in Obstructive Sleep Apnea Patients with Various Apnea-Hypopnea Index. Life. 2022;12:1080.

[5] Zammit D, et al. Current Trends in Orthognathic Surgery. Medicina. 2023;59:2100.

[6] Rodrigues MM, et al. Volumetric evaluation of pharyngeal segments in obstructive sleep apnea patients. Braz J Otorhinolaryngol. 2018;84(1):89-94.

[7] Lin KY, Eow PY, Kohli S, Math SY. Correlation of Medical Comorbidities and Upper Airway Measurements among Dental Patients at Risk of Developing Obstructive Sleep Apnea. Clin Pract. 2022;12:284-298.