Can a Deviated Septum Cause Breathing and Sleep Problems?
A stuffy nose does not always mean you have a cold or allergies. If one side of your nose seems blocked most of the time, a deviated septum may be making it harder for air to move through your nasal passages.
Some people have a crooked septum and never notice it. For others, it can lead to mouth breathing, nosebleeds, snoring, or trouble breathing through the nose. An ENT exam can help determine whether the shape of your septum is part of the problem.
What Is a Deviated Septum?
A deviated septum means the wall inside your nose is not sitting in the center. This wall, called the nasal septum, is made of bone and cartilage and separates the right and left sides of your nose.
If the septum leans too far to one side, it can make one nasal passage smaller than the other. That can leave less space for air to move through. Some people only notice a slight difference in breathing, while others may feel blocked on one side of the nose.
A deviated septum does not always make your nose look crooked from the outside. In many cases, the change is completely inside the nose and cannot be seen just by looking at your face.
It is also very common to have a mild deviation and never know it. Small changes in the septum may not cause any symptoms at all. It usually becomes more noticeable when it starts limiting airflow or makes it harder to breathe comfortably through your nose.
What Causes a Deviated Septum?
A deviated septum can happen for several reasons. Some people are born with a crooked septum, while others develop one as their nose grows or after an injury. You might not even know you have one until you start having trouble breathing through your nose.
Here are the most common causes of a deviated septum.
1. Born With a Deviated Septum
Some people are born with a nasal septum that is already off-center. This can happen while the nose is developing before birth or if the septum shifts during delivery.
However, having a deviated septum from birth does not always mean you will have breathing problems. If the deviation is small, you may go years without noticing anything unusual about your nose.
2. Changes as Your Nose Grows
Your nose changes as you grow, and so does the bone and cartilage that make up your nasal septum. Sometimes, these structures grow unevenly, causing the septum to lean more toward one side.
A slight deviation may become more noticeable as you get older. For example, you might find that one nostril feels more blocked than the other or that breathing through your nose takes a little more effort.
3. Nose Injuries or Trauma
A nose injury is another common cause of a deviated septum. A strong impact to the face can push the nasal septum out of place, even if your nose does not break.
This can happen from everyday accidents or activities, such as:
Contact sports: Getting hit in the face while playing basketball, football, or other sports.
Falls: Landing on your face or hitting your nose against a hard surface.
Car accidents: Hitting your nose or face during a collision.
Physical fights: Taking a direct blow to the nose.
Other accidents: Bumping your nose hard enough to damage or shift the cartilage.
You do not always need to have a broken nose to develop a deviated septum. Sometimes, the impact is enough to move the cartilage inside your nose without causing an obvious injury.
Injuries that happen during childhood can also affect how the septum develops. As the nose continues to grow, the deviation may become more noticeable, even years after the original injury.
What Are the Most Common Deviated Septum Symptoms?
Not everyone with a deviated septum has symptoms. Only 5% to 15% experience severe symptoms that require septoplasty.
Here are some signs to look out for:
Ongoing nasal congestion
Difficulty breathing through one or both nostrils
Blockage on one side of the nose
Mouth breathing, especially during sleep
Frequent nosebleeds
Facial pain or pressure
Headaches
Snoring or noisy breathing at night
Reduced sense of smell
Postnasal drip or runny nose
Recurring sinus infections
Sleeping on one side to breathe more easily
Keep in mind that these symptoms do not always mean you have a deviated septum. Allergies, sinus infections, and other nasal conditions can cause similar problems.
If your nose frequently feels blocked or you have trouble breathing through it, an ENT specialist can examine your nasal passages and help determine what's causing the problem.
How Can a Deviated Septum Cause Breathing Problems?
Deviated septum breathing problems happen when the crooked septum reduces the amount of room available for air to travel through the nose.
How noticeable this feels depends on the location and severity of the deviation. Some people have only mild stuffiness. Others may feel as though they cannot get enough air through one side of their nose.
Reduced Airflow Through the Nasal Passages
When one side of the nasal cavity is narrower, air has less room to pass through it. That is why one nostril may consistently feel harder to breathe through than the other.
The blockage can become even more noticeable when you have allergies, a cold, or another condition that causes swelling inside the nose.
If breathing through your nose feels difficult, you may naturally start breathing through your mouth instead. This is especially common while sleeping.
Frequent mouth breathing can leave your mouth and throat feeling dry. You may wake up needing water or notice that your throat feels uncomfortable in the morning. Significant nasal blockage can also disturb sleep.
During the day, ongoing congestion may simply make normal activities less comfortable. A dry mouth, blocked nose, and constant need to breathe through the mouth can become frustrating during conversations, meals, work, and daily routines.
Breathing Problems During Exercise
A deviated septum may become more noticeable when you are active.
When you exercise, your body needs to move more air. If one or both nasal passages are narrow, nasal breathing may feel more difficult. You may find yourself switching to mouth breathing sooner than expected.
This does not necessarily mean a deviated septum is affecting your fitness or athletic ability. It simply means the nasal obstruction may become easier to notice when your breathing demand increases.
If you regularly feel that your nose limits your breathing during workouts, sports, or other activities, an ENT evaluation can help determine whether the septum or another nasal condition is responsible.
Nosebleeds, Dryness, and Sinus Problems
A crooked nasal septum can change the way air moves through the nose. In some people, the surface of the septum becomes dry, which can increase the chance of nosebleeds.
A significant deviation may also interfere with normal sinus drainage in some patients. When this happens, it may contribute to repeated sinus problems. However, a deviated septum is only one possible factor. Allergies, infections, nasal polyps, and chronic inflammation can also affect the sinuses.
If you keep getting sinus symptoms, it is important to look at the whole nasal cavity rather than assuming the septum is the only cause.
Can a Deviated Septum Cause Snoring or Sleep Apnea?
Yes, a deviated septum can contribute to snoring and breathing problems during sleep. When one side of your nose is blocked, you may breathe through your mouth more often, snore, or have trouble finding a comfortable sleeping position.
But what about the connection between a deviated septum and sleep apnea?
A deviated septum does not directly cause obstructive sleep apnea, but nasal blockage can make breathing problems worse for people who already have the condition. Sleep apnea happens when the upper airway repeatedly becomes blocked during sleep, often involving the throat, tongue, or soft palate.
Snoring alone does not mean you have sleep apnea. However, certain symptoms may suggest a more serious breathing problem, including:
Pauses in breathing during sleep
Gasping or choking at night
Frequent morning headaches
Excessive daytime sleepiness
Trouble concentrating
Waking with a dry mouth or sore throat
If you notice these symptoms, talk to your doctor. A sleep study can help determine whether you have sleep apnea.
Treating a deviated septum may improve nasal breathing and reduce some nighttime symptoms, but septoplasty is not a guaranteed treatment for sleep apnea. The right approach depends on what's causing your airway to become blocked.
How to Fix a Deviated Septum?
Treatment depends on how much the deviated septum bothers you.
If you have a mild deviation with few or no symptoms, you may not need treatment at all. If allergies or swelling are making the blockage feel worse, medicines may help control those additional problems.
However, medicine cannot physically straighten a crooked nasal septum. Surgery is needed to correct the structure itself.
Can Medicines Ease Congestion From a Deviated Septum?
Medicines may be helpful when swelling or allergies are making your nasal passages feel even narrower.
Depending on the cause of your symptoms, your doctor may recommend:
1. Antihistamines
Antihistamines may help if allergies are causing sneezing, a runny nose, or swelling inside your nasal passages.
2. Nasal steroid sprays
These sprays reduce inflammation inside the nose. They can be especially helpful when allergies or chronic nasal swelling are adding to your congestion.
3. Decongestants
Decongestants temporarily reduce swelling inside the nose. They may provide short-term relief when congestion is making breathing harder.
It is important to remember that these treatments manage swelling and congestion. They do not move or straighten the nasal septum.
Be careful with decongestant nasal sprays. Using some types for more than a few days can cause rebound congestion, which may leave your nose feeling even more blocked once the medicine wears off.
What Is Septoplasty?
If the structural blockage is causing ongoing symptoms, your ENT may discuss septoplasty.
Septoplasty is surgery used to straighten and reposition a deviated nasal septum. During the procedure, the surgeon reshapes, moves, or removes parts of the cartilage or bone that are blocking the nasal passages.
Septoplasty is generally performed through the inside of the nose. That means there is usually no visible incision on the outside when septoplasty is performed by itself.
The goal is not to create a perfectly straight septum for appearance alone. The main goal is to provide more room for airflow when the deviation is causing functional problems.
Most septoplasty procedures are done on an outpatient basis, meaning patients can usually go home the same day. Initial recovery often takes a week or two, although deeper healing continues for longer.
Results can vary from one person to another. Your ENT can explain what type of improvement is realistic based on your nasal anatomy and other causes of congestion.
What Is the Difference Between Septoplasty and Rhinoplasty?
Septoplasty and rhinoplasty both involve the nose, but they have different goals.
Septoplasty focuses mainly on the structures inside the nose. Its purpose is to correct a deviated septum and improve nasal function.
Rhinoplasty changes the external shape or appearance of the nose.
For example, someone may want septoplasty because they cannot breathe comfortably through one nostril. Another person may want rhinoplasty because they want to change the size, shape, or angle of their nose.
Sometimes both procedures are performed together. This may be called a septorhinoplasty.
Your surgeon can explain which procedure makes sense based on whether your concern is breathing, appearance, or both.
When Is Septoplasty Recommended for a Deviated Septum?
You do not need septoplasty simply because an exam shows that your septum is crooked.
Many people have some degree of septal deviation and never need surgery. The decision is usually based on how much the obstruction affects your breathing, sleep, comfort, and daily life.
Your ENT may discuss septoplasty when you have problems such as:
Persistent nasal blockage despite appropriate medical treatment
Trouble breathing comfortably through the nose
Nasal obstruction that affects exercise or physical activity
Sleep disruption related to nasal blockage
Frequent nosebleeds associated with dryness of the septum
Recurring sinus problems when the deviation is interfering with drainage
Symptoms that interfere with work, sleep, or everyday activities
A significant structural obstruction found during an ENT examination
Before recommending surgery, your doctor may also look for other causes of nasal congestion.
For example, a person may have both a deviated septum and enlarged turbinates. Someone else may have allergies, nasal polyps, sinus inflammation, or nasal valve problems in addition to the septal deviation.
Finding all the causes of the blockage is important because straightening the septum will not necessarily fix congestion caused by another condition.
The goal of treatment is not to make an X-ray, scan, or nasal exam look perfect. It is to help you breathe more comfortably and address the symptoms that are affecting your life.
Final Thoughts
A deviated septum is common and does not always need treatment. But if it causes ongoing nasal congestion, breathing problems, or trouble sleeping, it may be time to have it checked.
Medications can help reduce swelling and congestion, but they cannot straighten a crooked septum. If symptoms continue, surgery called septoplasty may be an option.
Since allergies and other nasal conditions can cause similar symptoms, an ENT evaluation can help identify what's really causing the blockage.
At Colorado Voice Clinic in Greenwood Village, CO, Dr. David Opperman can examine your nasal passages, discuss your symptoms, and help you find the right treatment for your breathing concerns.
Call Colorado Voice Clinic at 303-844-3000 to request a consultation.
FAQs
1. Can a deviated septum get worse with age?
A deviated septum may become more noticeable as you get older. Changes in your nasal tissues, allergies, or ongoing inflammation can make an existing blockage feel worse. However, this does not always mean the septum itself is becoming more crooked.
2. Can a deviated septum heal on its own?
No. A deviated septum cannot straighten itself because it involves the bone and cartilage inside your nose. Medicines and nasal sprays may help reduce congestion, but they cannot correct the crooked septum. Septoplasty is the surgical treatment used to straighten it when necessary.
3. How do I know if I have a deviated septum?
One common sign is having one nostril that feels more blocked than the other, even when you are not sick. You may also experience frequent nosebleeds, mouth breathing, or difficulty breathing through your nose. However, these symptoms can have other causes.
4. Can you fix a deviated septum without surgery?
You can manage some symptoms without surgery, but you cannot physically straighten a deviated septum with medicine or home remedies. Nasal steroid sprays, antihistamines, and saline rinses may help if swelling or allergies are adding to the blockage. If the crooked septum itself is causing significant breathing problems, your doctor may recommend septoplasty.
5. Is it safe to live with a deviated septum?
Yes. Many people live with a deviated septum without experiencing serious problems. If it does not affect your breathing, sleep, or daily activities, treatment may not be necessary. However, persistent nasal blockage, frequent nosebleeds, or ongoing sleep problems are worth discussing with an ENT specialist.
6. Does everyone with a deviated septum need surgery?
No. Surgery is usually considered when a deviated septum causes ongoing symptoms that do not improve with appropriate medical treatment. If your deviation is mild and you can breathe comfortably, you may not need surgery.
7. Can a deviated septum cause headaches?
A deviated septum may contribute to facial discomfort or certain types of headaches in some people, particularly when parts of the nasal cavity are in contact. However, most headaches are not caused by a deviated septum. Migraines, allergies, and other conditions may cause similar symptoms, so a proper evaluation is important.
8. Will fixing a deviated septum stop snoring?
Septoplasty may help reduce snoring when nasal blockage is a contributing factor, but it does not guarantee that snoring will stop. Snoring can also come from relaxed tissues in the throat, tongue position, or obstructive sleep apnea.
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