Deviated Septum and Sleep Apnea: What To Know

An estimated 80% of us have a misalignment in the nose that makes one nasal cavity larger than the other. ¹ A severe misalignment – called a deviated septum – can make breathing difficult and affect your sleep apnea treatment, especially if you have nasal allergies. So it’s important to find out if you have one and whether you need treatment.

What is a deviated septum and what causes it?

Your nasal septum is “deviated” when the bone and cartilage divides your nose into two severely uneven nasal cavities. People can develop a deviated septum at birth or as a result of injury.

How does a deviated septum affect my CPAP treatment?

As we shared in our post on CPAP and summer allergies: If you have the “trifecta” of deviated septum, environmental allergies, and a nasal pillows CPAP mask, talk to your doctor about whether a nasal or full face mask would work better for you during allergy season.

Can a deviated septum cause sleep apnea?

No. Some online medical sources claim that a deviated septum can cause sleep apnea by restricting the nasal passage to your upper airway. But what actually happens in these cases is: The patient already has an obstruction in his/her airway, and the restricted nasal passage makes it worse. Apneas increase and symptoms are easier to notice. So if anything, a deviated septum can help reveal sleep apnea in some patients, though it doesn’t cause the condition by itself.

Do I have a deviated septum?

Most people with a deviated septum don’t know they have one – mainly because they don’t notice or even have any symptoms. ² Talk to your doctor if you’ve experienced any of these, especially on a frequent basis:

• Obstruction of one or both nostrils
• Nosebleeds
• Noisy breathing during sleep
• Awareness of the nasal cycle (meaning if you’re noticing when obstructions in your nasal cavity switch from one nostril to the other)
• Preference for sleeping on a particular side ³

Your doctor can usually diagnose this by looking up your nose with a bright light to visually examine your septum. This test should be painless.

Of course these symptoms could be caused by other temporary or chronic conditions, so be confident in your diagnosis before starting treatment. WebMD even suggests having an ear, nose and throat (ENT) doctor verify your diagnosis first. ²

Should I treat my deviated septum?

Most deviated septums don’t require treatment. But if yours is to blame for constant nosebleeds or sinus infections, you should ask your doctor about the pros and cons of the following common treatment options:

• An adhesive strip to keep your nasal passages open;
• Medication, which only treat symptoms, not the condition itself (e.g. decongestants, antihistamines, nasal steroids); or
• Surgery, called a septoplasty: A surgeon makes a small incision in the septum and straightens the nasal bone and cartilage to enable equal breathing out of both nostrils. While the side effects of this surgery are minor, be sure to discuss them with your doctor before having the procedure. Also, this procedure is usually not for children, since nasal cartilage grows until around age 18. ⁴