When I interviewed Dr. Soroush Zaghi, Medical Director of The Breathe Institute, the last thing I expected to hear was, “I’m scheduled for a septoplasty next week.” Wait — the expert is getting treated for the very condition he treats regularly? When I asked why, Dr. Zaghi said simply: “I was envious of my patients because they are doing so well and rubbing it in my face.” He’d had a deviated septum since tenth grade, when he was hit in the nose with a basketball. Having tried other solutions, he was finally ready to breathe better.
That conversation stuck with me because it illustrates something I see constantly in my work as The Sleep Ambassador®: people live with compromised breathing for years, even decades, without realizing how much better they could feel.
What Is a Deviated Septum?
Your nasal septum is the thin wall of bone and cartilage that divides your nasal cavity into two halves. When this wall is shifted to one side — which is more common than most people realize — it’s called a deviated septum.
A deviated septum can be present at birth, develop during the aging process, or result from an injury to the nose. Many people never know they have one because symptoms can be mild or absent. But for others, the impact on daily breathing and sleep quality is significant.
How to Tell If You Have a Deviated Septum
Here’s a simple self-test you can try right now:
- Place your index finger on one side of your nose, closing off that nostril.
- Breathe in through the open nostril.
- Switch sides and repeat.
- Notice: Was one side noticeably more restricted than the other?
If one side feels significantly more blocked, you may have a deviated septum. The next step is to see an ear, nose, and throat (ENT) specialist for a proper evaluation.
Symptoms That Warrant Medical Attention
A deviated septum can cause a range of symptoms that many people simply accept as “normal.” If you experience any of the following, it’s worth getting checked:
- Difficulty breathing through one or both nostrils — This is the most common symptom, often worse on one side.
- Chronic nasal congestion — Especially if it consistently affects one side more than the other.
- Frequent nosebleeds — A deviated septum can dry out the nasal lining on the narrower side.
- Recurrent sinus infections — Poor drainage from blocked nasal passages creates an environment for infection.
- Noisy breathing or snoring — Especially during sleep, when throat muscles relax further.
- Morning headaches or facial pain — Often related to poor airflow and sinus pressure overnight.
- Sleep disruption — Waking up feeling unrefreshed, dry mouth, or gasping during sleep.
Common Myths About Deviated Septum
In my conversations with leading ENTs and breathing specialists, several misconceptions come up repeatedly:
Myth: A deviated septum is always caused by an injury.
While trauma from sports, accidents, or falls is a common cause, many deviated septums are congenital — present from birth — or develop over time through the aging process.
Myth: A deviated septum causes allergies.
Allergens trigger allergy attacks. A deviated septum is a structural issue. However, a deviated septum can make allergy symptoms feel worse because the compromised nasal passages can’t clear allergens as effectively.
Myth: Surgery is the only option.
Many people with mild to moderate deviation find relief through non-surgical approaches. Surgery (septoplasty) is typically recommended only when symptoms are severe and other treatments haven’t helped.
Non-Surgical Solutions for Better Breathing
Before considering surgery, these approaches may significantly improve your breathing:
Nasal Dilators
A nasal dilator like Mute gently opens the nasal airway from inside the nose. For someone with a deviated septum, the difference can be immediate and dramatic — many of my clients describe an “aha moment” when they first feel air flowing freely through a previously restricted passage.
Nasal Breathing Retraining
Many people with deviated septums develop a habit of mouth breathing, which compounds sleep problems. Programs like the Hobson Institute Breathing Clinic’s virtual retraining course can help you reestablish healthy nasal breathing patterns.
Optimize Your Sleep Environment
Keeping bedroom air clean and humidified, using hypoallergenic bedding, and managing allergens can reduce the congestion that makes a deviated septum feel worse.
When to Consider Septoplasty
If non-surgical approaches aren’t providing adequate relief and your breathing difficulty is affecting your sleep, energy, and quality of life, a septoplasty may be the right choice. This outpatient procedure straightens the nasal septum to improve airflow. Your ENT will evaluate your specific anatomy and symptoms to determine if you’re a good candidate.
Breathing Is Foundational
I’ll leave you with this thought from James Nestor’s groundbreaking book Breath: The New Science of a Lost Art: breathing is not just automatic — it’s something we can and should optimize. Whether your breathing challenge is a deviated septum, congestion, or simply bad habits, addressing it will improve your sleep, your energy, and your overall well-being.
Don’t settle for compromised breathing. Talk to a specialist, try the solutions that make sense for your situation, and give yourself the gift of breathing — and sleeping — well.
For additional detail on deviated septum symptoms, causes, and treatment options, read my article on Mute Snoring: Deviated Septum.
By Nancy H. Rothstein, MBA, The Sleep Ambassador®