Deviated septum and sleep apnea: What you need to know

Quick takeaways

• A deviated septum isn’t usually the sole cause of sleep apnea.¹
• The structure of your nasal cavity can affect your breathing.
• Breathing issues caused by a deviated septum might make the symptoms of obstructive sleep apnea (OSA) worse.⁸

Does a deviated septum cause sleep apnea? While the structure of your nose can affect your breathing and may make snoring or breathing through the mouth more noticeable, it’s not usually the sole cause of sleep apnea.¹ Learn more about the connection between a deviated septum and sleep apnea below.

How a deviated septum and obstructive sleep apnea are connected

Obstructive sleep apnea (OSA) is the most common form of sleep apnea, affecting almost 1 billion people worldwide.² OSA is a condition where the muscles around the throat relax to the point of collapse, restricting airflow during sleep. Breathing may become shallow or stop for seconds to minutes at a time. A deviated septum isn’t usually the sole cause of obstructive sleep apnea (OSA), but there’s a connection between the two conditions.

What is a deviated septum?

The septum is the thin wall that divides your nose into two sides.³ If you have a deviated septum, this means that the wall is crooked or has shifted out of place. As a result, a deviated septum might block airflow on one or both sides of the nose.

A deviated septum may be present at birth due to fetal development or injury during delivery. In adults, it can result from a sudden impact that shifts the septum out of place, such as a car accident or sports injury.²¹ In some people, this limited airflow can contribute to snoring or breathing through the mouth during sleep.

How a deviated septum affects breathing during sleep

When the septum is out of place, nasal breathing can become more difficult, which may lead to breathing through your mouth during sleep.

Breathing through the mouth for extended periods of time may lead to:

• Less stable airways
• An increased risk of snoring
• A higher likelihood of disrupted breathing during sleep

How doctors check for both conditions

If you’re concerned about a deviated septum, a doctor can perform a nasal exam to determine how much your septum has shifted. They may also recommend tests such as acoustic rhinometry or nasal endoscopy.⁶

Acoustic rhinometry uses sound waves to measure the structure of your nasal passages. A nasal endoscopy uses a small camera to examine the inside of your nose.

A doctor may also recommend a sleep study, which collects information about your breathing, oxygen levels, and sleep patterns overnight. This is the only way to diagnose sleep apnea and determine its severity.⁷

Overlapping symptoms

Deviated septum and obstructive sleep apnea (OSA) share several symptoms. Both can cause daytime sleepiness, tiredness, and restless sleep.

A deviated septum can also cause nasal congestion, which may contribute to the development or worsening of OSA.⁸ In some cases, difficulty breathing through the nose may cause sleep apnea to go undiagnosed.

A severely deviated septum can also impact oxygen levels and sleep quality, which may further affect overall health.¹⁰ People experiencing both conditions often report reduced quality of life.⁸

Snoring is another shared symptom. However, it’s important to distinguish between simple snoring and sleep apnea. A sleep study can help provide clear answers.

Treatment options and what to expect

If you have a deviated septum and obstructive sleep apnea, talk to your doctor about treatment options that may help manage your symptoms.

Surgery to correct the septum

Septoplasty is a surgical procedure used to straighten a deviated septum.¹¹ During this procedure, a surgeon repositions the septum to improve airflow through the nose.

Sometimes septoplasty is combined with turbinate reduction, which reduces the size of structures inside the nose that can contribute to congestion.¹²

Many people report improved breathing and sleep quality after surgery. However, it’s important to have realistic expectations. Septoplasty may improve nasal breathing and CPAP comfort, but it usually does not cure sleep apnea on its own.

CPAP therapy with a deviated septum

Continuous positive airway pressure (CPAP) therapy helps keep your airway open during sleep by delivering a steady stream of air through a mask.¹⁰

Blocked nasal passages can make CPAP harder to use. In some cases, nasal surgery may improve CPAP tolerance.¹⁸

If nasal obstruction is an issue, switching to a different CPAP mask may help. Talk to your doctor or equipment provider about available options. Combining septum surgery with CPAP therapy may improve overall results.¹⁸

Nonsurgical treatments

If surgery isn’t appropriate, several non-surgical options may help:

• Nasal dilators to help keep nasal passages open¹³
• Medications such as nasal sprays, decongestants, or antihistamines for congestion¹⁴
• Sleeping on your side to improve airflow¹⁵
• Weight management and lifestyle changes

Always talk to a doctor before starting any new medication or treatment.

Making the right treatment decision

Surgery is typically recommended only for significant nasal blockage. A sleep study before and after treatment can help measure improvement.

Doctors often recommend a step-by-step approach, starting with non-invasive treatments before considering surgery.^19,20

Treatment plans should be personalized based on your symptoms, anatomy, and overall health. Consulting with a healthcare provider is the best way to determine the right approach.

Long-term outlook

After treatment, ongoing monitoring can help track your sleep quality. Even after septoplasty, some people may still need CPAP therapy.¹⁸

Many people experience improved quality of life when both nasal blockage and sleep apnea are properly managed. Regular follow-up with your doctor can help maintain these improvements.

To learn more about your sleep health, take our sleep assessment today.

Sources

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2. Source: Benjafield AV, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687-698. https://doi.org/10.1016/S2213-2600(19)30198-5
3. Source: Alghamdi, F. S., Albogami, D., et al. (2022). Nasal septal deviation: A comprehensive narrative review. Cureus, 14(11), e31317. https://doi.org/10.7759/cureus.31317
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9. Source: Hassanpour, S. E., Moosavizadeh, S. M., et al. (2014, July 1). Pulmonary artery pressure in patients with markedly deviated septum candidate for septorhinoplasty. https://pmc.ncbi.nlm.nih.gov/articles/PMC4236997/
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