Jan 22, 2021

Interviewer: Fixing a deviated septum to improve your sleep or stop snoring. Does that work? Dr. Marc Error is an ENT at University of Utah Health. Septoplasty is the name of the surgery for straightening out a deviated septum, but can that improve sleep or stop snoring? That's what we want to find out today.

Dr. Error: Well, a septoplasty can be used to help with breathing through the nose, but it's not a reliable treatment for snoring. Snoring is actually caused because the muscles in the throat, the tongue, the side walls, the roof of the mouth is one big muscular tube, and when you fall asleep, those muscles relax. And as they relax, they narrow that tube and it becomes a floppy tube, and you continue to need the same amount of air through your nose or mouth. And you try to force that air through that floppy tube behind your tongue or side walls, and it starts to vibrate causing snoring. So the sound of snoring and even sleep apnea problems are not coming from the nose itself.

Now having said that, there are a lot of people that if you change and make the nose more open through a septoplasty can have some improvement of their snoring because it changes how they can close their mouth now while they're sleeping, which changes the muscle positions as well as just changes the aerodynamics of air flow. So some people can benefit from a septoplasty, but it's not a reliable treatment.

Interviewer: And when people come in and are determined to get, you know, get that operation done to either improve their snoring and their sleep, where do they get the impression that that's going to cure? Because as you just explained it's actually happening someplace else. It's happening in your throat.

Dr. Error: Well, it's a very common misconception and this is usually either from personal experience where . . . You know, my wife notices that when my nose is plugged, I breathe a little louder. I may snore at night or even my kids, when I watch my kids at night, when they have a cold and aren't breathing very well through their nose, they tend to make a little bit more sound and to snore more. So it's a common misconception or they may have had a friend that had a septoplasty done and their friends as well, you wouldn't believe, yeah, I breathe better through my nose, but my snoring has improved. So the issue that we run into is it's just a common misconception that a septoplasty cures all snoring. It can definitely improve it, but it's not a cure all.

A septoplasty is done to improve nasal obstruction, you make it so you can breathe easier through the nose, but it's not . . . it's unreliable on the snoring side of things. If you have snoring and nasal obstruction, and the nasal obstruction bothers you, definitely address the nasal obstruction. That could be done through various ways. Septoplasty is one of them, but I wouldn't recommend doing an invasive procedure like a septoplasty just to help snoring alone unless the nasal obstruction bothers you.

Interviewer: And if a patient came into your office and you have those conversations, they were under the impression that, you know, "The cure for my snoring or my poor sleep is to get my septum straightened out." And you've had the conversation you just had with me and now I understand that not necessarily reliable for that if during the day I do have that obstruction in my nasal area and it affects my breathing, then that would be a good time to get a septoplasty, but not specifically for snoring or sleep, what would you recommend to them at that point if, you know, snoring or sleep is their concern?

Dr. Error: Well, if snoring and sleep is the main concern then sometimes being seen by a sleep provider can help out where they can really evaluate what's going on during sleep. Snoring is a warning sign of something called sleep apnea. Sleep apnea is where your throat collapses enough that your oxygen level starts to go down. Obstructive sleep apnea is almost always accompanied with some type of snoring or sounds. And so getting that checked out is very important because having your oxygen levels go down at night can have other side effects that you'd want to get treated.

So if your main concern is sleeping issues and snoring, seeing a sleep provider is a good place to start. If you're having trouble with nasal obstruction, then definitely seeing an ear, nose, and nose, and throat or otolaryngologist can help to be able to evaluate and see what's going on, and why are you having trouble breathing through your nose. If you're having a lot of nasal obstruction and you're starting to notice it more, there are some noninvasive ways and things you can do to try to see if treating that does help the sleep quality such as using a topical nasal steroid spray regularly can reduce inflammation, it can make it so the nose is more open. By doing so, you may notice that the sleep improves. If this is the case where treating nasal obstruction improves your sleep, then that's a more realistic thing that going in and seeing a ear, nose, and throat, and asking about a septoplasty is more appropriate.

For Patients