Have you been told that you have a deviated septum or been diagnosed with obstructive sleep apnea (OSA) and had a doctor want to check inside your nose? If so, then it’s important that you understand what it means to have a deviated septum and how it may be connected to obstructive sleep apnea.

Once you have this information, you and your doctor can figure out a treatment plan that will work for you and your body. Finding the right treatment for you can make a big difference, not only in how you sleep but also for your overall health and even for your life expectancy.

What’s a Deviated Septum?

Your septum is the combination of cartilage and bone that separates your nasal passages and your nasal cavity into two sides, the right and the left. When your septum isn’t centered, but is instead crooked or shifted, it’s called a deviated septum. About 80 percent of people have some deviation in their septum. Most people don’t notice this, because it’s not severe enough to cause symptoms. If your septum deviation is more significant, you may have symptoms associated with it.

These symptoms arise because your septum is blocking airflow on one side of your nose. You may experience:

• Trouble breathing, especially on one side of your nose
• Snoring
• Nasal congestion
• Nosebleeds
• Headaches or face pain
• Loud breathing
• Loss of your sense of smell
• Lower quality sleep due to breathing difficulty
• Lower quality of life

You may have a deviated septum because you were born with it, it developed as you grew, or your nose was injured. Whatever the cause, you and your doctor should decide what treatment options might work best for you.

A Deviated Septum and Sleep Apnea

Most of the time, a deviated septum alone won’t cause obstructive sleep apnea. After all, OSA is still caused by your airway collapsing while you’re asleep.

However, there are connections between septum deviation and OSA. In one large study that looked at national health records, people with a deviated septum were 4.39 times more likely to also be diagnosed with sleep apnea. However, this study also showed that this number went up as a person’s body mass index (BMI) increased. This makes sense, since obesity is also a risk factor for developing OSA. It indicates that having a deviated septum may make it more likely to develop sleep apnea, but so do other factors.

Other researchers looked at whether the type and location of a septum deviation might make it more likely to develop sleep apnea. They found that sleep apnea was only associated with deviations of the front part of the septum, not the rest of it. Thus, you may want to talk to a healthcare provider about the specifics of your deviated septum before you connect it to obstructive sleep apnea.

Researchers note that more work needs to be done to understand this connection better. Since OSA is caused by airway collapse in the throat, not the nose, there may be other factors influencing either breathing or the way the research is conducted that we don’t understand yet.

Either way, having a deviated septum can add to your breathing problems at night and contribute to struggles you might have during the day. For instance, a deviated septum can make it harder for you to breathe and cause nasal congestion, which makes getting air even more difficult. You may end up breathing through your mouth instead of your nose at night. Mouth breathing can contribute to snoring and sleep quality problems, along with dry mouth and hoarseness. If you’re already dealing with these symptoms because of OSA, having a deviated septum may make it all worse.

A deviated septum can also make it harder for you to use a continuous positive airway pressure (CPAP) machine to treat sleep apnea. If it’s hard for you to get enough air through your nose, you may not stick with CPAP treatment the way you need to for OSA. A deviated septum is known to make CPAP treatment more difficult, so treating it may help you treat your OSA too.

Treating a Deviated Septum

There are a number of good treatments available to help with a deviated septum. You should work with a healthcare professional to figure out which one of these is right for you.

Medications

A number of medications can help treat symptoms caused by a deviated septum, particularly if they’re mild or you only have them once in a while. Doctors may advise you to take decongestants or antihistamines or use a steroid spray in your nose. These don’t fix the deviated septum, but they do help reduce inflammation in your nose to keep your airways as open as possible.

Surgery

The only way to truly repair a deviated septum is to have surgery. It’s called a septoplasty, and the doctor who performs it will reshape your septum so it’s straighter and doesn’t block airflow when you breathe through your nose. Most people who have a septoplasty find that it works for them and that they don’t have to deal with a lot of complications.

This surgery alone likely won’t resolve obstructive sleep apnea, particularly if your OSA is moderate or severe, because it doesn’t do anything to reshape the part of your upper airway that tends to collapse. However, having a septoplasty can make it a lot easier to use a CPAP machine. If you can breathe with more ease through your nose, then you can use the machine the way it was designed and get help for your sleep apnea when you do.

People do report improvement in some sleep apnea symptoms after surgery, but this is likely due to the fact that it helps the symptoms of a deviated septum that overlap with those of sleep apnea, like snoring and poor sleep.

Talk to Your Doctor

If you’re living with both a deviated septum and OSA, talk to a healthcare professional about how these conditions may be working together to make you feel worse. You can discuss what treatment options for a deviated septum might be right for you, since treating it can also make treating OSA easier. If you try some medicinal treatments and they don’t help, your doctor can help you find a surgeon who can repair your septum. They may also recommend sleep apnea surgery.

If you know you’re living with OSA or a deviated septum, or you suspect you might have both conditions, your doctor can help. They can get you the sleep study or nasal testing you need to determine what’s going on. Once you know, you can make better and more informed decisions about your own medical care.

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On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

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