What Is a Deviated Septum?
A deviated septum describes abnormal crookedness in the wall separating the nostrils. This wall, called the septum, consists of both cartilage and bone. While it's normal for the septum to be a little asymmetrical, too much crookedness is considered a deformity and can make it difficult to breathe through the nose. The severity of symptoms doesn't always correlate with the degree of deviation, as even a relatively small deviation can cause significant symptoms.
Some people have their septum deviated during childbirth, while others develop a deviated septum later in life by a sports injury, car crash, or illness. Age-related changes and prior nasal surgeries can also contribute to changes in nasal airflow and septal alignment.
What Is Sleep Apnea?
Sleep apnea is a disorder that involves an excessive number of breathing interruptions during sleep. In obstructive sleep apnea (OSA), a person's breathing repeatedly stops or slows down during sleep because the airway becomes blocked or narrows.
In central sleep apnea (CSA), breathing interruptions occur because the brain doesn’t send proper signals to the muscles that control breathing. But OSA is by far the most common form of sleep apnea.
Don’t Just Test Your Sleep. Understand It.
Measure key sleep metrics and review your results with a licensed sleep-care provider. Discuss sleep issues and options to make restless nights a thing of the past.
Can a Deviated Septum Cause Sleep Apnea?
A deviated septum can contribute to obstructive sleep apnea by partially obstructing airflow through the nasal passages. The shape of a deviated septum can physically obstruct the airway on its own and create resistance to airflow. The deviation may also contribute to an airway obstruction by prompting crust to develop in the nose that blocks airflow or causing a turbinate, which is a nasal cavity, to enlarge and obstruct airflow.
While a deviated septum alone is rarely the sole cause of obstructive sleep apnea, it can be one of several factors that contribute to airway narrowing.
Symptoms of a Deviated Septum
The most common deviated septum symptoms are a stuffy nose, particularly in only one nostril, difficulty sleeping, and difficulty breathing through the nose. The increased nasal congestion may lead to more mouth breathing.
Other possible symptoms include a lower quality of life, headaches, frequent sinus infections (chronic sinusitis), and pain in the face. Some people also report reduced exercise tolerance, frequent nosebleeds, or waking up with a dry mouth due to nighttime mouth breathing.
Symptoms of Sleep Apnea
Obstructive sleep apnea symptoms include feeling sleepy during the daytime, loudly snoring, gasping or choking during sleep, experiencing pauses in breathing during sleep, and having morning headaches. Additional symptoms may include difficulty concentrating, memory problems, depression, and waking up feeling unrefreshed despite sleeping enough hours.
Not everyone experiences all of the same symptoms. In some cases, a bed partner becomes aware of the disorder first, noticing signs like snoring, gasping, choking, snorting, or not breathing for periods of time while asleep at night.
Does Fixing a Deviated Septum Help Sleep Apnea?
Fixing a deviated septum through a surgery called septoplasty can improve obstructive sleep apnea symptoms by removing the obstruction caused by the crooked septum or a related enlarged turbinate in the nasal passage. This removal allows air to better flow through the nasal airway, either reducing lapses in breathing throughout the night or making it easier for a sleeper to tolerate continuous positive airway pressure (CPAP) therapy.
Studies suggest that nasal surgery often improves subjective sleep quality, nasal breathing, snoring and CPAP adherence. However, septoplasty alone is generally considered an adjunctive treatment rather than a standalone treatment for obstructive sleep apnea.
When to See a Doctor
If you suspect you may be experiencing a deviated septum, obstructive sleep apnea, or both disorders, you should talk to your doctor. Common symptoms of a deviated septum include nasal congestion, trouble breathing through the nose, and difficulty sleeping. Common symptoms of obstructive sleep apnea include loud snoring, daytime tiredness, choking or gasping for air during sleep, and morning headaches.
A doctor can ask questions about your symptoms and medical history, as well as conduct examinations and order tests to figure out what is causing your symptoms. An ear, nose, and throat (ENT) doctor often works with people who have deviated septums, whereas a sleep specialist works with those who have sleep apnea. A visual exam or scope can confirm a deviated septum, and an overnight sleep study or a home sleep test can confirm whether or not a person has sleep apnea.
Frequently Asked Questions
Can a deviated septum cause snoring?
A deviated septum can cause snoring by narrowing the nasal passages and blocking airflow. While loud snoring is a common symptom of obstructive sleep apnea, not everyone who snores has the disorder.
Can a deviated septum cause sinus problems?
Chronic sinus problems, such as recurring sinus infections, can be symptoms of a deviated septum. Air pockets that are naturally attached to the deviated septum can end up closer or attached to the sinuses, which may interfere with sinus drainage or lead to more frequent or hard-to-treat infections. Poor drainage caused by nasal obstruction may also contribute to facial pressure, congestion, and recurrent inflammation of the sinus passages.
Can a septoplasty cure sleep apnea?
Research shows that septoplasty surgery doesn't cure obstructive sleep apnea in most people who undergo it, but it does improve the disorder and make CPAP therapy easier to use. Studies have found that when a person has a deviated septum, undergoing a septoplasty is likely to improve their sleep quality and reduce daytime tiredness, even if sleep apnea isn't cured.
For these reasons, a septoplasty is often recommended as part of a broader treatment plan for obstructive sleep apnea, rather than as an intended cure.
Can I use CPAP with deviated septum?
Some people with a deviated septum can use CPAP therapy with little problem, while others find that CPAP therapy is difficult to tolerate due to the deviated septum. Studies have found that undergoing septoplasty can make CPAP therapy easier to tolerate among people who struggle with it due to a deviated septum.
