[elric]

I share your concerns about surgery. The way I understand it, the difficulty lies in choosing the right surgery (or surgeries) for the right patient. The supposed gold-standard diagnostic approach is a drug induced sleep endoscopy, where an ENT looks at your airway while you sleep. The problem is that being sedated is not the same as being asleep. It's possible to do this "right", but that is much more time consuming than just shooting people up with propofol and scoping them while they're knocked out.

One thing to keep in mind is that surgery might still be useful even if it doesn't get you off CPAP: being able to use lower CPAP pressures could increase comfort and adherence.

I've been putting off my own septoplasty because it all sounds extremely unpleasant, so yeah.

[bobthepanda]

IME septoplasty was bad for like a week (constantly nosebleeding more than I’ve ever done in my life) but in the grand scheme of surgery its a fairly low pain, fast recovery, at least compared to other ones I’ve done like ACL construction.

The ones they generally don’t recommend in the US are those that involve airway or jaw modification; they have fairly low success rates, you’ll have trouble eating for months, and they can come with a whole host of nasty side effects like permanent uncontrolled nasal drip. Plus, in general US medicine tries not to recommend major surgeries if alternatives are good enough or better, not only to reduce cost and recovery, complications etc, but also because general anesthesia itself is risky.