AT HER lowest point, Zali Friswell would wake up multiple times a night, gasping for air.

She would get as little as four hours of poor-quality sleep the night before a game, while the anxiety created by her sleeping issues only compounded the problem.

So, in February this year, at the age of just 21, she took an extraordinary step; she underwent an invasive three-hour operation, where she was "opened up" above her teeth and through the underside of her jaw, all the way back to her throat.

It was a painful and traumatic experience, but one she knew she had to go through to improve not just her football but – more importantly – her quality of life.

"Sleep apnoea runs in the family, but a 19-year-old with moderate sleep apnoea is rare," Friswell tells AFL.com.au.

"I'd be constantly tossing and turning, and I'd wake up gasping for breath, which is scary. With sleep apnoea, you stop breathing multiple times throughout the night. My sleep study said that I stopped breathing over 30 times, and the longest break went for over 20 seconds, which is weird, because I can't even do that when I'm awake.

"I'd stop breathing, I'd jolt, and then I'd wake myself up, intentionally or not intentionally. I'd notice sometimes when it'd be a big wake-up, but then sometimes I wouldn't, which is why I'd wake up so tired. And I'd struggle to fall and stay asleep."

After two years of sleep issues, Friswell had been working with a sleep psychologist who suggested she undergo a sleep test overnight. It took three months for the results and eventual diagnosis, which came just before Geelong's nail-biting preliminary final loss to Brisbane in 2023.

The first attempted solution was a form of mouthguard to wear at night, which it was hoped would eventually shift her bottom jaw forward to help open up her airway. It helped a little but also created somewhat of an underbite and didn't properly solve the issue.

"I struggled a lot during footy and sleeping before games, but I just thought it was normal. Then when I got diagnosed – of course, I knew it was an issue – but the diagnosis then created this anxiety around sleep because of the quality of what I was having," she says.

"When I got my wisdom teeth done, the surgeon, Dr Richard Wood in Geelong, said there's a surgery to help with sleep apnoea. I was just about to start the (2024) season, so I didn't want to go through all that.

"It was around our last round, against Adelaide, and before the game, I had four hours sleep. Four hours' sleep for anyone is terrible, but for a person with sleep apnoea, it's even worse, because that quality of time is not great. Even if I had seven hours, compared to a regular person with seven hours, it'd be totally different.

"I have data on my watch comparing it and I'd (technically) be awake for two hours when I thought I was sleeping. Whereas now, it's 30 minutes.

"It just flicked a switch, and I just wanted to feel better and feel like a regular person. Basically, a week later, I got in with Richard Wood and he said, straight up, 'Well, I can see why [the mouthguard] wasn't working', which was because of my main obstruction (was) through my mouth. He could also tell from my facial structure – which is an amazing and weird thing – and I couldn't breathe at all through my nose, which I didn't know. I haven't broken it, it's just my natural genetics."

Then came the deeply invasive, three-hour operation and long recovery, which she documented on social media.

"They moved my upper jaw forward eight millimetres, my bottom jaw forward four, and then my chin forward two, and then they extended my nose. I've got plates in my chin, my nose, my cheeks and they all stay in there," she says.

"I knew the extent of the surgery that I was going in for, which was great, but if I knew every single detail, I think it would have freaked me out more. When I came out of surgery, it was a 10/10 pain.

"I couldn't speak for a few days. I was writing on notepads. I couldn't really eat much. I was on endone and everything. The first day was terrible, but days four to 14 was the worst.

"The sleep was terrible. I was wake up at 1am for like three hours in severe pain. The headaches made me feel like someone was crushing my head. They reckon, because I'm an athlete, that the swelling wasn't as bad, but I looked like a chipmunk. I had bruising down all the way down my neck and chest.

"I had bolts screwed into my mouth for eight weeks, then they were screwed out again. They had bands around there to keep it, and I'd have to change them every night. One night, it actually took an hour and a half, and my parents were having to reach right back into my mouth. I'd bleed, and would struggle to open my mouth wide enough.

"Then I had this stupid mouthguard that was fitted in my top and bottom teeth, so it moved up and down, and it stayed there to keep my jaw in line. I was on liquids (yoghurt, blended soup, smoothies) and eating through a syringe for two weeks, so I lost a few kilos."

With the operation in February, Friswell had four months to recover before pre-season began. Three of those months were designated as non-contact for her optional training sessions, with Dr Wood purposely inserting an extra wire in her chin to strengthen her jaw, given the risks of her occupation.

"I was numb from my eyes down for about a month and a half, then it was just my chin. But I've got all sensations now," she says.

"I just can't explain how hard it was, mentally and physically – I couldn't do gym, running, bike, anything.

"I couldn't sweat for six weeks, and I couldn't do gym and running for eight weeks because of the (inadvertent) clenching of the face, and the up and down movements.

"I found out that because I wasn't breathing through my nose at all, I wasn't getting enough oxygen (while exercising). Hopefully this season, I'll be able to recover, perform and run better. I feel like I'm already a very good runner, but I'll be better with my breathing.

"I feel like everyone does things in their off-season to be able to get better for the next year. And this is one of those that I just needed to do, just not for footy, but to be able to live my life."

Friswell generally averaged six hours of poor quality sleep per night, and while the sleep apnoea hasn't been completely cured, her symptoms have certainly been eased.

"The nasal passage was fixed, but there's only a certain extent that they can move your mouth. But the sleep quality is absolutely amazing. I have data on my watch back to 2023 to now, and the sleep quality is just so different," she says.

"Day to day, I've got energy waking up, I'm not as groggy, not as tired, less headaches and migraines. All the symptoms are nowhere near as high as they used to be. I was having a lot of visual migraines in high school, and the lack of sleep didn't help.

"I used to try and live off coffee to get through a day. I didn't let it stop (me) from what I was doing, but I had to adapt. Interstate games I struggled a lot, not sleeping in my own bed, and it evolved into an anxiety around sleep.

"But there's such a weight off my shoulders now. It feels so good."

There's still some maintenance work to be done, including Invisalign clear braces to help re-align her teeth with her new jaw, and her new face still catches a few off guard.

"Of course, I still have sleep apnoea now, but it's not to the extent that it was. My facial structure has changed a bit. I feel strong in my chin, especially," she says.

"There's a few little [speech] changes, but I don't think it's changed fully. More of the facial changes - the nose has definitely changed. A few of the girls were joking about a free nose job, and I said, 'I don't think it was free'.

"It is an expensive surgery, but you've got to put money into your health.

"The prep for it was pretty big and everything, and missing all those foods that I couldn't chew for a while. I remember having my first steak, and it was eight or nine weeks post-op. It tasted good, but if you haven't worked a muscle in a while, it's very weak.

"I'm looking forward to seeing how it impacts my body more, that I can just perform better, breathe better, everything like that.

"It was a life-changing surgery that I don't regret."