The objective was to investigate whether tongue base suspension with uvulopalatopharyngoplasty (UPPP) is beneficial on polysomnography analysis for sleep quality in patients with obstructive sleep apnea (OSA) anatomically classified as Fujita type III (small tonsils and a bulky tongue base). In the retrospective study, the charts of 36 patients with OSA that underwent tongue base suspension with UPPP from 2012 through 2015 were reviewed. The surgical outcome measured according to Sher's classification (AHI reduction > 50% and AHI < 20 per hour as success group, otherwise as failure group). The pre- and post-operative sleep quality parameters were evaluated, and the total sleep time changes were evaluated based on electroencephalography study, slow wave sleep, sleep efficiency, rapid eye movement sleep percentile, and Epworth sleep scale scores. Respiratory, the outcomes of polysomnography analysis were then compared between the successful surgery and surgical failure groups during a 1-year follow up. Total arousals and reduced respiratory arousal indices, along with unchanged periodic leg movement and spontaneous electroencephalography arousal indices, were observed in the successful surgery group but not in the surgical failure group. There were 66% resulted in surgical success by this surgery, and 34% as in failure group according to Sher's criteria. Patient sleep quality was further improved by reducing the respiratory arousal index and increasing the rapid eye movement sleep percentile during the 1-year follow up.