u/Frosty-Region1229

30 year old male here. I can manage my sleep apnea reasonably well with a combination of CPAP, dental appliance (very minimal advancement), side sleeping, and keeping my weight low. By "reasonably well" I mean I can go to work and do a decent job, but I still have some pretty bad days with brain fog / fatigue, maybe due to some unresolved UARS.

My concern is that my DISE shows almost complete tongue base collapse onto my epiglottis, and I heard that it's only going to get worse as I get older.

Would it be worth it for me to get double jaw surgery right now as a preventative measure?

My AHI is 20 and I might not actually need both CPAP + MAD simultaneously, but I use both because it allows me to use less pressure and minimal advancement.

I'm looking to get the surgery with an Italian surgeon, but I live in Canada.

Would there be any Canadian orthodontists who are willing to cooperate with international surgeons to do the pre-surgery orthodontics?
(Preferably in Ontario, but nearby provinces are OK too)