The nasal septum is a thin wall of cartilage and bone that divides the inside of the nose into two separate passages. While it should ideally run straight down the center, a physical obstruction is common. This structural issue, known as a deviated septum, is a frequently overlooked cause of chronic nasal blockage that can affect a person’s ability to breathe properly, particularly during sleep.
Understanding the Deviated Septum
A deviated septum occurs when this dividing wall is displaced, leaning significantly to one side of the nasal cavity or sometimes forming an S-shape. This displacement is present in a large percentage of the population, though only severe cases cause noticeable symptoms. The condition can be congenital, developing in the womb or resulting from an injury during a difficult birth.
More frequently, the deviation is acquired later in life due to trauma, such as a blow to the face or a broken nose. Regardless of the cause, the crooked septum directly reduces the cross-sectional area of one or both nasal passages. This restriction increases the resistance to air moving through the nose, forcing the body to work harder to pull oxygen in.
How Nasal Obstruction Impacts Sleep Quality
The reduced airflow from a deviated septum can compromise sleep quality. Nasal blockage often forces an individual to become a mouth breather during the night, which leads to increased snoring. The turbulent airflow over the soft tissues in the throat causes the characteristic snoring sound, disturbing sleep for both the individual and their bed partner.
Constant mouth breathing during sleep results in a dry mouth and throat, contributing to poor oral health and discomfort. The chronic struggle for air can also lead to fragmented sleep architecture, meaning the sleeper spends less time in deep and REM sleep cycles. This lack of restful sleep often manifests as daytime sleepiness, irritability, and difficulty concentrating.
While a deviated septum does not directly cause Obstructive Sleep Apnea (OSA), the nasal resistance it creates can significantly worsen existing OSA symptoms. The obstruction can make the airway more prone to collapse and interfere with the effective use of positive airway pressure devices like CPAP machines. Correcting the nasal passage can therefore improve comfort and compliance with other sleep disorder treatments.
Identifying the Problem and Non-Surgical Management
A person should consult a physician, often an ear, nose, and throat specialist, if they experience persistent nasal blockage, frequent nosebleeds, or difficulty breathing. Diagnosis typically begins with a physical examination, where the doctor visually inspects the nasal passages and the septum. This inspection helps determine the extent of the deviation and whether other issues, like swollen nasal tissues, are contributing to the obstruction.
If the symptoms are mild, conservative, non-surgical management is the first step. Over-the-counter options like external nasal strips or internal nasal dilators can physically open the nostrils and provide temporary improvement in airflow, especially at night. Nasal steroid sprays may be recommended to reduce inflammation of the nasal lining, which can exacerbate the physical blockage.
Other conservative measures include using saline nasal rinses or a Neti-Pot to flush out mucus and keep the passages moist. Sleeping with the head elevated can also help reduce nighttime nasal congestion. However, these non-surgical remedies only address the symptoms of inflammation and congestion; they cannot correct the underlying structural deviation.
When Septoplasty Becomes Necessary
When conservative treatments fail to provide adequate relief from chronic nasal obstruction, septoplasty is the definitive solution. This surgical procedure straightens the displaced bone and cartilage of the nasal septum. The goal of the surgery is purely functional, aiming to maximize airflow through the nasal passages to restore proper breathing.
During the outpatient procedure, the surgeon makes an incision inside the nose, lifts the mucous membrane, and then trims, reshapes, or repositions the deviated portions of the cartilage and bone. The procedure typically takes between 30 and 90 minutes, depending on the complexity of the deviation. Patients can usually return home the same day.
Initial recovery, including the removal of internal splints or packing, often takes about one to two weeks. However, the nasal tissues require a longer period to fully stabilize, with complete healing potentially taking three months to a year. When successful, septoplasty significantly improves nasal patency, directly addressing the physical cause of sleep-disrupting nasal obstruction.