A common question concerns the relationship between a deviated septum, a structural irregularity in the nose, and sleep apnea, a condition affecting breathing during sleep. While distinct, these health concerns can influence each other. This article explores each condition and their potential interplay.
Understanding a Deviated Septum
The nasal septum is the thin wall of cartilage and bone that divides the inside of the nose into two separate nasal passages. A deviated septum occurs when this wall is significantly off-center or crooked. Many individuals, estimated to be around 80%, have some degree of septal deviation, though it often causes no symptoms. This misalignment can be present from birth or result from an injury to the nose later in life.
When the deviation is substantial, it can lead to noticeable symptoms, primarily affecting breathing. The most common symptom is difficulty breathing through one or both nostrils, often feeling like a persistent nasal obstruction. This reduced airflow can cause frequent sinus infections because normal drainage pathways are impaired. Other indications may include recurrent nosebleeds, facial pain, or noisy breathing and snoring during sleep.
Understanding Sleep Apnea
Sleep apnea is a medical condition characterized by repeated pauses in breathing or periods of very shallow breathing while asleep. These interruptions can last from a few seconds to minutes and may occur many times throughout the night. The most prevalent form is Obstructive Sleep Apnea (OSA), which happens when throat muscles relax during sleep, causing soft tissues to collapse and block the airway.
This blockage prevents air from reaching the lungs, leading to a drop in blood oxygen levels. The brain responds by briefly waking the individual to restore breathing, often with a gasp or snort. These frequent awakenings disrupt the sleep cycle, even if the person doesn’t fully remember them.
Common symptoms include loud snoring, often with observed pauses in breathing. Individuals may also experience gasping or choking sensations during sleep, followed by daytime sleepiness or fatigue. Morning headaches, difficulty concentrating, and irritability are also frequently reported due to fragmented sleep.
The Link: How a Deviated Septum Can Impact Sleep Apnea
A deviated septum can significantly influence breathing patterns, particularly during sleep, creating conditions that may contribute to or worsen sleep apnea. When the nasal passage is narrowed due to a septal deviation, it increases the resistance to airflow through the nose. This often forces individuals to breathe through their mouth, especially when lying down.
Mouth breathing can cause the lower jaw and tongue to shift backward, further narrowing the upper airway. The increased effort required to breathe through a partially obstructed nose can also destabilize the muscles that keep the upper airway open. Consequently, a deviated septum can exacerbate the mechanisms that lead to obstructive sleep apnea. While a deviated septum alone may not be the sole cause of sleep apnea, it can be a substantial contributing factor to its development or severity.
Diagnosis and Treatment Approaches
Diagnosing a deviated septum typically involves a physical examination by an ear, nose, and throat (ENT) specialist. The doctor uses a nasal speculum or endoscope to view and assess the septum’s alignment. A CT scan may also further evaluate nasal and sinus structures.
For sleep apnea, the primary diagnostic tool is a sleep study, known as polysomnography. This overnight test monitors brain activity, heart rate, blood oxygen levels, and breathing patterns during sleep. Home sleep tests are also available as a convenient alternative for some individuals.
Treatment for a symptomatic deviated septum often involves a surgical procedure called septoplasty. This operation reshapes or repositions the septum’s bone and cartilage to straighten it and improve nasal airflow. While medications like decongestants or nasal steroid sprays can temporarily alleviate mild symptoms, they do not correct the underlying structural issue.
Managing sleep apnea typically begins with lifestyle adjustments, such as maintaining a healthy weight and avoiding alcohol before bedtime. Continuous Positive Airway Pressure (CPAP) therapy is a common and effective treatment, using a machine that delivers pressurized air through a mask to keep the airway open. Custom-fitted oral appliances can also help by repositioning the jaw and tongue to prevent airway collapse.
When a deviated septum is present alongside sleep apnea, addressing the nasal obstruction can be an important part of a comprehensive treatment plan. Improving nasal airflow through septoplasty can alleviate some sleep apnea symptoms. It can also enhance CPAP therapy’s effectiveness and tolerability, making consistent use easier. While septoplasty may not cure sleep apnea, it can significantly reduce its severity and improve the success of other treatments.