How can I alleviate snoring caused by a deviated septum?

Managing Snoring Due to Deviated Septum

For snoring caused by a deviated septum, elevating your head with a bed wedge may provide modest symptom relief, but surgical correction through septoplasty is the most effective long-term solution for improving nasal airflow and reducing snoring. 1, 2

Non-Surgical Options for Immediate Relief

• Bed wedge elevation (30-45 degrees) can help reduce snoring by improving airflow and decreasing negative pressure in the pharynx that contributes to upper airway resistance 1
• External nasal dilators (like Breathe Right strips) may provide some benefit for snoring in patients with septal deviation, though evidence shows inconsistent results and they are not recommended as a definitive solution for OSA 3
• Internal nasal dilators reduce nasal resistance by 31-65% and can decrease snoring noise in some patients with habitual snoring, but have minimal effect on sleep architecture or breathing patterns 3

Why These Solutions Have Limited Effectiveness

• The European Respiratory Society notes that nasal dilators are not recommended for effectively reducing snoring or improving sleep disordered breathing in OSA 3
• For patients with significant septal deviation, non-surgical interventions provide only temporary and partial relief as they don't address the underlying structural problem 1, 2
• Approximately 80% of the general population have off-center septums, but only about 26% have clinically significant deviation causing symptoms 2

Surgical Intervention for Long-Term Relief

• Septoplasty is the recommended surgical intervention for caudal septal deviation causing nasal obstruction and is more appropriate than rhinoplasty for addressing functional breathing issues 2
• Studies show that nasal surgery for deviated septum can significantly decrease respiratory distress index (RDI), apnea index (AI), and oxygen saturation index (OSI) in patients with obstructive sleep apnea 4
• In some cases (approximately 19% of patients), snoring and OSA may be completely resolved with septoplasty alone 4

Before Considering Surgery

• The American Academy of Otolaryngology recommends at least 4 weeks of medical therapy with intranasal corticosteroids before surgical intervention 2
• Comprehensive medical management should include saline irrigations for nasal hygiene and treatment of any underlying allergic component 2
• Anterior septal deviation is more clinically significant than posterior deviation as it affects the nasal valve area responsible for more than 2/3 of airflow resistance 1

Practical Approach to Managing Your Snoring

1. Short-term relief: Use a bed wedge (30-45 degrees) to elevate your head while sleeping 1
2. Try nasal dilators: External or internal nasal dilators may provide some temporary relief 3
3. Medical therapy: Use intranasal corticosteroids and saline irrigations for at least 4 weeks 2
4. Consult an otolaryngologist: If symptoms persist, seek evaluation for possible septoplasty, especially if you have significant anterior septal deviation 1, 2

Important Considerations

• Nasal surgery alone may not completely resolve snoring if you have multiple contributing factors to your sleep-disordered breathing 5
• Baseline nasal breathing patterns can help predict surgical outcomes - those with the lowest baseline nasal breathing epochs may benefit most from surgery 5
• Laser-assisted outpatient septoplasty (LAOS) is a minimally invasive option that has shown improvement in both nasal obstruction and snoring symptoms in over 90% of patients 6