Deviated septum and sleep apnoea: What you need to know

Quick takeaways

• A deviated septum isn’t usually the sole cause of sleep apnoea.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 apnoea (OSA) worse.⁸

Does a deviated septum cause sleep apnoea? 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 apnoea.¹ Learn more about the connection between a deviated septum and sleep apnoea below.

How a deviated septum and obstructive sleep apnoea are connected

Obstructive sleep apnoea (OSA) is the most common form of sleep apnoea, 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 apnoea (OSA), but there’s a connection between the two conditions. Before exploring that connection, it’s helpful to understand what a deviated septum is.

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. For example, it’s possible to develop a deviated septum after an auto accident or high-impact 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

Imagine what would happen if the wall between two rooms suddenly shifted. You may have trouble getting into and out of one of the rooms. This is what happens when you have a deviated septum. Nasal breathing might become more difficult, causing you to breathe through your mouth.

Breathing through the mouth for extended periods of time may lead to long-term breathing challenges. For example, breathing through the mouth is associated with:

• Less stable airways
• An increased risk of snoring
• A higher likelihood of developing OSA.⁴

How doctors check for both conditions

If you’re concerned about a deviated septum, a doctor can perform a nasal exam. This exam helps determine how much your septum has shifted. Your doctor may also recommend acoustic rhinometry or nasal endoscopy.⁶

Acoustic rhinometry analyses how sound waves bounce off the internal structures of your nose. This noninvasive test provides valuable information about your nasal passages.

A nasal endoscopy uses a camera to examine the inside of the nose. To perform this test, a doctor inserts a thin, flexible tube equipped with a camera and light into the nose. Performing a nasal endoscopy can help a doctor determine the severity of your deviated septum.

A doctor may also prescribe a sleep test, which collects information about your body while you sleep. Your doctor can use this information to determine if you have a sleep disorder like sleep apnoea.

Overlapping symptoms

Deviated septum and obstructive sleep apnoea (OSA) have some overlapping symptoms. Both conditions can cause daytime sleepiness, tiredness and restless sleep. A deviated septum can also cause severe nasal congestion, contributing to the development and worsening of OSA.⁸ In some people, congestion or difficulty breathing through the nose might cause sleep apnoea to go undiagnosed.

A severely deviated septum can cause poor sleep quality and low levels of oxygen in your blood – both of which have been linked to OSA.¹⁰ As a result, people with both conditions may report poorer quality of life.⁸ For example, if you don’t get enough sleep, you might find it harder to stay alert while driving, pay attention at work or keep up with your household chores.

Snoring can be caused by both obstructive sleep apnoea and deviated septum. It’s essential to know the difference between simple snoring and OSA, and taking a sleep test can help you get the right answers.

Treatment options and what to expect

If you have a deviated septum and obstructive sleep apnoea, don’t be discouraged. Talk to your doctor or sleep care team to learn more about treatment options that may help you manage your symptoms.

Surgery to correct the septum

Septoplasty is a type of surgery used to correct deviated septum. During this procedure, a surgeon moves the septum back to the middle of the nose where it belongs.¹¹ Addressing a deviated septum may improve nasal airflow, resulting in less noticeable snoring or breathing through the mouth.

In some instances, septoplasty is combined with turbinate reduction. This procedure makes the turbinates – the pieces of spongy tissue – in the nose smaller.¹² When these tissues are enlarged, they can cause nasal congestion and difficulty breathing. During turbinate reduction, a surgeon uses specialised instruments to shrink the enlarged tissue.

After surgery, many people report better sleep and improved airflow through their nasal passages. The key is to have realistic expectations. Septoplasty and/or turbinate reduction might help with nasal breathing.

CPAP therapy with a deviated septum

Continuous positive airway pressure (CPAP) therapy is designed to help people with sleep apnoea breathe consistently throughout the night. It helps keep the airway open while you sleep.¹⁰

Some people with blocked nasal passages may find CPAP difficult to use. In some cases, nasal surgery can help people adjust to CPAP.¹⁸

If nasal obstruction is making CPAP difficult to use, switching to a different mask may help. Talk to your doctor or sleep care team or CPAP equipment provider about the mask options available and if switching is a good idea for you. Combining septum surgery with ongoing CPAP therapy may help you breathe even easier.¹⁸

Nonsurgical treatments

If surgery isn’t an option, nonsurgical treatments might help. Nasal dilators, for example, are designed to help improve airflow by keeping the nasal passages open while you sleep.¹³

Over-the-counter and prescription medications can also help with nasal congestion. For example, steroids may help reduce inflammation, while decongestants are designed to dilate blood vessels.¹⁴ Antihistamines may be helpful if allergies are causing your nasal congestion. Antihistamines block your body’s response to allergy triggers,¹⁴ such as pollen and pet dander. However, it’s important to talk to a doctor before trying a new medication.

Some people find that changing sleep positions improves airflow. You might notice an improvement if you sleep on your side instead of sleeping on your back.¹⁵

Making the right treatment decision

Surgery is often reserved for severe nasal blockages. If you decide to have surgery, it’s important to have a sleep test before and after the procedure. This makes it possible to determine if your deviated septum was contributing to your OSA symptoms.

Many doctors recommend a step-by-step approach for treating deviated septum and sleep apnoea. This means starting with the noninvasive treatments and testing before you have surgery. For example, your doctor might recommend taking an antihistamine or using nasal dilators before they consider performing septoplasty.^19,20

There’s no one-size-fits-all treatment plan for deviated septum or sleep apnoea. Your treatment should be tailored to your symptoms and body structure. Consulting with your doctor or sleep care team is the optimal way to determine the right treatment approach for your needs.

Long-term outlook

After surgery, long-term monitoring can help you track the quality of your sleep. Even if surgery improves your breathing, you may still need CPAP therapy after having septoplasty. The good news is that surgery often makes CPAP therapy easier to use.¹⁸

Many people report a better quality of life once they treat deviated septum and obstructive sleep apnoea. Follow up with your doctor or sleep care team to help manage your symptoms and determine the optimal path forward to improve your sleep quality.

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

This blog post contains general information about medical conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice, and should not be treated as such. You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider.

If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition, you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website. The views expressed on this blog and website have no relation to those of any academic, hospital, practice, or other institution with which the authors are affiliated and do not directly reflect the views of Resmed or any of its subsidiaries or affiliates.

References:

1. Freeman, S. C., Karp, D. A., & Kahwaji, C. I. (2023, May 1). Physiology, nasal. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK526086/
2. 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. 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
4. Lörinczi, F., Vanderka, M., Lörincziová, D., & Kushkestani, M. (2024). Nose vs. mouth breathing – acute effect of different breathing regimens on muscular endurance. BMC Sports Science Medicine and Rehabilitation, 16(1), 42. https://doi.org/10.1186/s13102-024-00840-6
5. Sowho, M., Sgambati, F., et al. (2019). Snoring: A source of noise pollution and sleep apnea predictor. SLEEP, 43(6). https://doi.org/10.1093/sleep/zsz305
6. Aziz, T., Biron, V. L., Ansari, K., & Flores-Mir, C. (2014). Measurement tools for the diagnosis of nasal septal deviation: A systematic review. Journal of Otolaryngology – Head and Neck Surgery, 43(1), 11. https://doi.org/10.1186/1916-0216-43-11
7. Gerstenslager, B., & Slowik, J. M. (2023, August 14). Sleep study. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK563147/
8. Yeom, S. W., Kim, M. G., et al. (2021). Association between septal deviation and OSA diagnoses: A nationwide 9-year follow-up cohort study. Journal of Clinical Sleep Medicine, 17(10), 2099-2106. https://doi.org/10.5664/jcsm.9352
9. 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/
10. Slowik, J. M., Sankari, A., & Collen, J. F. (2025, March 4). Obstructive sleep apnea. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK459252/
11. Watters, C., Brar, S., & Yapa, S. (2022, November 8). Septoplasty. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK567718/
12. Abdullah, B., & Singh, S. (2021). Surgical interventions for inferior turbinate hypertrophy: A comprehensive review of current techniques and technologies. International Journal of Environmental Research and Public Health, 18(7), 3441. https://doi.org/10.3390/ijerph18073441
13. Dinardi, R. R., De Andrade, C. R., & Da Cunha Ibiapina, C. (2014). External nasal dilators: Definition, background, and current uses. International Journal of General Medicine, 491. https://doi.org/10.2147/ijgm.s67543
14. National Cancer Institute. (n.d.). Seeking Relief from sinus congestion: Exploring medication options. NCI at Frederick. https://ncifrederick.cancer.gov/about/theposter/content/seeking-relief-sinus-congestion-exploring-medication-options
15. Marques, M., Genta, P. R., et al. (2017). Effect of sleeping position on upper airway patency in obstructive sleep apnea is determined by the pharyngeal structure causing collapse. SLEEP, 40(3). https://doi.org/10.1093/sleep/zsx005
16. Romero-Corral, A., Caples, S. M., et al. (2010). Interactions between obesity and obstructive sleep apnea. CHEST Journal, 137(3), 711-719. https://doi.org/10.1378/chest.09-0360
17. National Academies Press (US). (2004). Weight-Loss and maintenance strategies. Weight Management – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK221839/
18. Cohen JC, et al. Use of continuous positive airway pressure after rhinoplasty, septoplasty, and sinus surgery: a survey of current practice patterns. Laryngoscope. 2015;125(11):2612-2616. https://doi.org/10.1002/lary.25336
19. UCHealth. Deviated septum. https://www.uchealth.org/diseases-conditions/deviated-septum/
20. Stanford Medicine. Nasal surgery. https://med.stanford.edu/ohns/OHNS-healthcare/sleepsurgery/treatments/nasal_surgery.html
21. Hussain F. Hit it on the nose: deviated septum Q&A. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/hit-it-on-the-nose-deviated-septum-q-and-a