The Intriguing Link Between a Deviated Septum and Sleep Apnea

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Sleep apnea is quite a common condition that affects around 1/4 of men and slightly fewer women.

It can negatively affect your overall quality of life and lead to some quite serious combinations.

Illustration of a woman who suffer from Deviated septum and sleep apnea

Trying to find solutions to reduce sleep apnea is a priority for most patients living with the condition.

Because a deviated septum also affects how you breathe, many people have wondered if there is a connection between a deviated septum and sleep apnea.

So let’s take a look.

What is Sleep Apnea?

Sleep apnea is when your breathing repeatedly stops and starts throughout the night.

There are two main types of sleep apnea:

  • Obstructive sleep apnea – this is the most common type, and it is when the muscles in the throat relax, causing breathing to be obstructed.
  • Central sleep apnea – this is when there is a problem with the signals the brain sends to control the muscles responsible for breathing.

Some people have complex sleep apnea which is a combination of obstructive and central.

Symptoms of Sleep Apnea

It sometimes isn’t obvious at first that you have sleep apnea because you aren’t aware of what happens when you are asleep.

Some common signs that you could have sleep apnea include:

  • Being sleepy in the daytime, even after a full night’s sleep
  • Loud snoring
  • Other people telling you that you have stopped breathing during the night
  • Waking up with a dry mouth
  • Waking up with a headache
  • Difficulty with staying asleep
  • Irritability
  • Difficulty holding your attention

Complications of Sleep Apnea

Sleep apnea doesn’t just leave you feeling tired and irritable the next day.

It can also contribute to a wide range of quite serious health conditions. These can include:

  • asthma
  • a weakened immune system
  • high blood pressure
  • heart disease
  • type 2 diabetes
  • COPD
  • low blood oxygen levels
  • high cholesterol
  • fatty liver disease
  • stroke
  • infertility

Causes of Sleep Apnea

The exact cause of sleep apnea often isn’t known, but there are some factors that can make it more likely that you will develop the condition. These include:

  • Being obese
  • Having a large neck due to excessive fat tissues
  • Getting older
  • Your genetics
  • Smoking tobacco
  • Drinking alcohol
  • Having large tonsils
  • Sleeping on your back

What is a Deviated Septum?

Your septum is the thin wall between your two nostrils.

In some people, the septum can be displaced to one side, and this means that one nasal passage is smaller than the other.

Showing an illustation of deviated septum to be able what is the best sleeping position for deviated septum

The smaller nostril can easily become blocked, which can reduce the airflow into your lungs.

An injury can cause a deviated septum to the nose, or it can be something that you are born with.

What are the Symptoms of a Deviated Septum?

Many people who have a deviated septum are unaware of it, especially if the deviation is quite narrow.

There are symptoms that can indicate a deviated septum however, including:

  • Difficulty breathing through one or both nostrils
  • Nosebleeds
  • Facial pain
  • Noisy breathing during sleep
  • Being aware of which nostril you are breathing out of
  • Preferring to sleep on one side

What is the Link Between a Deviated Septum and Sleep Apnea

Both a deviated septum and sleep apnea can cause you breathing problems when you are asleep, and both can disturb your night.

The two conditions are definitely linked because they affect your respiratory system, but the situation is a little more complicated than one causing the other.

Having a deviated septum can’t cause sleep apnea because the causes of sleep apnea are linked to the throat area, but having a deviated septum (and specifically an obstructed nostril) is a risk factor associated with sleep apnea.

So what does this mean?

Well, if you are predisposed to getting sleep apnea due to other risk factors, such as having a large neck, a deviated septum could be enough to trigger the start of sleep apnea because of how it affects your breathing.

We mainly breathe through our nose, and nose breathing is important for many mechanisms that regulate our breathing.

When our nose is obstructed, and we are forced to breathe through our mouths alone, this can make our breathing more unstable, which can trigger obstructive sleep apnea.

Central sleep apnea may also be triggered because not being able to nose breathe can interfere with the communication between the brain and the breathing muscles.[1]

If you have already had sleep apnea and your septum has deviated, this can make your sleep apnea symptoms worse.[2]

So if you want to reduce your sleep apnea symptoms, considering your septum is an important part of the treatment process.

Can You Use a CPAP Machine with a Deviated Septum?

One of the most common treatments of sleep apnea is the use of a CPAP (continuous positive air pressure) machine.

A CPAP machine sends a constant flow of oxygen into your lungs, which can make sure that your oxygen levels stay stable and can prevent your airway from collapsing during the night.

A CPAP machine consists of a pump that pushes pressurized air through a tube and into a mask that you wear over your face.

The pressure of the air helps to prevent any blockages from occurring.

One of the decisions that you need to make when choosing a CPAP machine is the type of mask that you are going to wear, and this decision can be impacted by whether or not your septum is deviated.

There are three basic CPAP mask designs.

1) Nasal pillow mask

This mask uses a pillow that fits over your nostrils. It is useful if:

  • A fuller mask makes you feel claustrophobic.
  • You want to retain your full field of vision, and/or you want to continue to wear your glasses.
  • You want to keep any facial hair that could interfere with the seal of other mask types.

2) Nasal mask

This mask covers the entire nose. It is useful if:

  • You need high air pressure.
  • You move around a lot in your sleep.

3) Full-face mask

This mask covers your mouth and your nose. It is useful if:

  • You have a nasal obstruction such as a deviated septum.
  • You breathe through the mouth at night, even after using a nasal mask and a chin strap.

If you have a deviated septum, your only real option for a CPAP mask is a full-face design.

This, of course, has its downsides.

It could make you feel claustrophobic, it will mean your field of vision will be obscured, and you won’t be able to wear your glasses, and you may have to shave your facial hair off.

For this, and other reasons, many patients who have both conditions will seek treatment for their deviated septum to relieve their sleep apnea.

What are the Treatments for a Deviated Septum?

Because a deviated septum is a structural abnormality, no non-invasive treatment methods will resolve it.

The only option to cure a deviated septum is surgery.

For people with milder symptoms, reducing any inflammation and swelling can be enough to prevent the nostril from becoming obstructed. Medications can help with this:

  • Decongestants
  • Antihistamines
  • Steroid spray
  • Nasal strips

For more severe cases of a deviated septum, where the nostril has become obstructed, surgery is an option that can help.

This type of surgery is called a septoplasty and is generally safe.

A septoplasty is conducted under anesthetic and takes around an hour and a half.

The surgeon cuts the septum and removes the excess bone and cartilage that is causing the deviation.

Sometimes silicon splints are used to keep the septum straight.

A full recovery from septoplasty can take 3-6 months and it is important during this time not to disturb the nose too much. So you should avoid:

  • Bumping your nose
  • Wearing clothes that pull over your head
  • Blowing your nose

Will Septoplasty Cure Sleep Apnea?

A septoplasty is one of the primary treatment options for sleep apnea if it is present.

Correcting a deviated septum can broaden your choices of masks for your CPAP machine.

It can also improve oxygen levels, meaning that you can use your CPAP machine at a lower pressure level.[3]

Septoplasty can also improve sleep and quality of life in patients with sleep apnea.[4]

The evidence for the effect of septoplasty on sleep apnea symptoms themselves is a little more mixed.

Most studies haven’t found an improvement in sleep apnea on its own after septoplasty, which suggests that it can’t cure sleep apnea.[4]

But this doesn’t mean that septoplasty is useless when it comes to treating sleep apnea.

Improving the effectiveness of your CPAP machine can relieve your sleep apnea symptoms, and septoplasty can help with this.

Improving sleep quality can also help reduce your risk of some of the health complications associated with sleep apnea, so it is also important.

Because of this, many physicians consider treating a deviated septum as an important part of the treatment plan for sleep apnea, along with a spectrum of other treatments.

Other Treatments for Sleep Apnea

A septoplasty is just one of the treatment options you may be offered if you have sleep apnea, alongside a CPAP machine.

But these aren’t the only treatments that can help to reduce your sleep apnea.

There is a wide range of options available to you to help reduce your sleep apnea.

Alternative Machines

While the CPAP machine is the most well known device for treating sleep apnea, it isn’t the best option for everyone.

There are other machines available that work in slightly different ways to help keep your airways open.

Bilevel positive airway pressure (BiPAP) machine

  • The airflow changes when breathing in or out
  • Helps to push diaphragm down normally so that lungs can fill with air

Automatic positive airway pressure (APAP) machine

  • Props airway open
  • Adjusts air pressure based on needs

Dental devices

  • Help to keep airway open

Surgeries

Septoplasty isn’t the only surgery that can help with sleep apnea.

Surgeries that focuses on other areas of the face, mouth, and throat can also reduce your symptoms of sleep apnea.

Uvulopalatopharyngoplasty (UPPP)

  • Removal of soft tissue from the back of the throat and palate

Mandibular Mxillomandibular advancement

  • Fixes facial problems that could be worsening sleep apnea

Lifestyle Changes

There is a range of lifestyle behaviors that can affect your sleep apnea, so modifying these can help reduce some of your symptoms.

Weight loss

Sleep apnea is closely linked to obesity, and being overweight can increase your risk of developing sleep apnea.

The extra tissue in your throat can cause it to collapse more easily,[5] and being overweight can interfere with the mechanisms behind breathing and reduce the muscle tone needed to breathe normally.

Avoid sleep medications and alcohol

These can reduce the muscle tone in the back of throat, increasing the risk of it closing.+

Drinking alcohol or taking sleeping pills before you go to bed can make your sleep apnea symptoms more severe.

Sleep on your side instead of your back

Changing your sleep position can have a great impact on the severity of your sleep apnea.

When you sleep on your back, the pull of gravity can increase the risk of your throat collapsing.

Sleeping on your side can help to keep your airways open and reduce your sleep apnea symptoms.

Summary

  • Sleep apnea can lead to serious health consequences.
  • Many people with sleep apnea also have a deviated septum.
  • A deviated septum can reduce the effectiveness of CPAP machines and can make sleep problems worse.
  • There is a wide range of treatment options available to treat sleep apnea alongside correcting a deviated septum.

Final Thoughts

The relationship between deviated septum and sleep apnea is quite complicated.

There is definitely a link, but a deviated septum doesn’t cause sleep apnea on its own, and treating a deviated septum won’t cure sleep apnea.

However, it can increase the effectiveness of other sleep apnea treatments and improve your quality of sleep.

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