Can't Breathe? You May Have a Deviated Septum

A close-up of a young woman's nose and septum.

Breathing easily is often something we take for granted— until our ability to breathe easily stops. If you’ve experienced the familiar misery of trying to breathe through a congested or stuffy nose, especially at night, then you know every moment trying to breathe through your stuffed-up sinuses can feel like agony. 

You don’t have to be sick or suffering from allergies to experience congestion or nasal breathing issues. Instead, you may have a condition called a deviated septum. 

Maybe you’ve heard of a deviated septum but aren’t quite sure what that means, or how to identify if your difficulty breathing is a result of the condition. Discover how to identify and address a deviated septum, including treatment without surgery. 

What is a Deviated Septum?

A deviated septum— also known as a deviated nasal septum— is a condition where your septum is off-center or crooked. 

Your septum is the cartilage and bone in the center of your nose that divides your nasal cavity into two passages. A crooked septum can cause one of these passages to be smaller than the other leading to reduced airflow in your sinuses and difficulty breathing.

Deviated septum is a common condition for all age groups, with up to 80 percent of the population having a noticeable septal deviation when examined. But that doesn’t mean treatment is required. Many people have a deviated septum and never have bothersome symptoms. 

Most of these deviations are generally minor and will not cause breathing problems, which is why many people may not realize their septum is crooked. More severe cases though can cause breathing difficulty and may even require surgery to fix the issue. 

If you have a chronically blocked nasal passage, along with other common deviated septum symptoms, it may be time to address the issue. 

Deviated Septum Symptoms 

Common deviated septum symptoms include:

  • Nasal congestion where one nasal passage is more congested than the other
  • Difficulty Breathing
  • Frequent nosebleeds
  • Postnasal drip
  • Headaches and facial pain
  • Chronic or repeated sinus infections
  • Chronic sinusitis
  • Noisy breathing and snoring

Although many people with a mild condition don't report symptoms, a deviated septum that is more moderate to severe is likely to create a nasal obstruction. This obstruction makes it more difficult to breathe through the obstructed side of the nasal passage. However, sometimes the obstruction is noticed on the opposite side. 

When breathing, you continuously switch from one nostril to the other while directing airflow. This continuous switching is intentional and designed to prevent constant airflow from drying out and damaging the nostril's lining. 

This switching of airflow from one nostril to the other is referred to as the nasal cycle. And if you have a deviated septum and the obstruction occurs on the opposite side of the septal blockage, nasal breathing becomes especially difficult and often uncomfortable. 

Having a deviated septum with more severe blockage can also make you vulnerable to sleep apnea when left untreated. [1]

Obstructive sleep apnea (OSA) is a serious sleep disorder where the airway is partially blocked, or in some cases completely obstructed. These blockages contribute to hypertension, mood disorders and heart conditions such as heart failure or strokes. 

A common sleep apnea symptom is loud snoring. If you find yourself snoring, gasping for breath, or are told you stop breathing while asleep, it's important to get tested for sleep apnea and seek expert advice on whether your deviated septum is contributing to the disorder.

What Causes a Deviated Septum?

There are two main causes of a deviated septum. The first is that many people are simply born with the condition. It could develop in utero, or is caused by an injury to the nose during birth, or by pressure within the birth canal.

The second cause of a deviated septum is injury or trauma to the nose. This can be caused by several injuries including:

  • Automobile accidents
  • Sports injuries— particularly from contact sports like football or wrestling
  • Rough play
  • Getting struck in the nose by an object or another person

You can help reduce your risk of injury by always wearing a seatbelt while in the car, or wearing appropriate safety gear when you play sports.

A third, although less common cause of a deviated septum, is something that can’t be prevented— aging. As you age, the structure of your nasal cavity may change, which can cause or worsen a deviated septum.

How to Tell If You Have a Deviated Septum

If you experience any of the symptoms listed or have suffered an injury to your nose, you may have a deviated septum. 

Generally, a physical exam with an ENT (ear, nose and throat specialist) can determine whether your septum is deviated. Although you may be able to tell by looking in the mirror, you can also have a nose that looks completely straight and still suffer from the condition.

Can Nose Piercings Cause Breathing Problems?

Septum piercings have become very popular in recent years. Even before that, nose piercings were popular fashion statements. It’s very common for people to wonder if it’s okay to get a nose piercing when you have a deviated septum, or to worry that getting a nose piercing will cause snoring, difficulty breathing, or affect one’s sense of smell.

It is possible to get a septum piercing with a deviated septum— although the piercing may not be completely centered. Your septum piercing may also hurt more initially because of overactive septum nerves. But what about other breathing problems?

A nose piercing can lead to narrowed airways, swelling of your nostrils, or breathing obstruction— but only temporarily. As you adjust to a new piercing— like a septum piercing— you get used to the new object in your nose as your piercing heals. Once everything is healed, your breathing should return to normal.

However, an infection or an allergic reaction to the new jewelry can prevent healing and cause other problems. Signs of infection include:

  • Redness around the piercing that doesn't go away after a few weeks
  • Soreness or tenderness at the piercing site
  • Crusting, or a pus-like discharge
  • Swelling or pain at the piercing site

You can prevent infection by keeping the piercing site clean— your piercer will give you directions for this. If you have any allergies to metals used in body jewelry, let your piercer know ahead of time so you can prevent potential allergic reactions.

Nose piercings cannot affect your sense of smell either. This is because the piercings are in areas that contain minimal amounts of nerves. And with fewer nerves there, your new piercing is unlikely to hinder your ability to smell.

How to Fix a Deviated Septum

The only way to 100 percent fix a deviated septum is through nasal surgery. The main surgical procedure is called septoplasty— which evens out the size of your nasal passages by removing the excess bone or cartilage causing the obstruction. [2]

However, surgery may not be a feasible option for some because of the price, or if the surgery isn't covered by insurance. It may not even be necessary if your deviated septum is less severe.

Deviated Septum Treatment Without Surgery

There are treatment options for a deviated septum that don't require surgery. While these options will not correct a deviated septum because they aren’t addressing the structural issues, they can help reduce the congestion and symptoms associated with the non-deviated side. 

When you get congested or clogged on the “open” non-deviated side, it can feel miserable. Taking steps to open the “good” airway supports better breathing.

These treatment options include:

  • SinuSonic. This newer medical device is used by rhinologists as a non-addictive, non-drug solution for opening blocked airways and to help reduce sinus pain and congestion. It uses gentle acoustic vibrations— similar to humming— to help decongest sinuses naturally. It can help relieve non-structural related nasal congestion accompanying a deviated septum.
  • Decongestants. Whether in pill form or as a nasal spray, decongestant medications can help reduce stuffiness or nasal congestion when a deviated septum contributes to difficulty breathing. Prolonged use of decongestants however can potentially create a dependency on the medication.
  • Antihistamines. This common allergy treatment can help prevent allergen-related congestion, or other allergy symptoms like a runny nose. If inflamed sinuses from mold, dust mites, or seasonal allergens are stuffing you up completely, they can be a great complementary solution to non-drug solutions like the SinuSonic, although some may cause drowsiness.
  • Nasal steroid spray. Steroid nasal sprays can help reduce swelling in your nasal cavity and help with drainage, but overuse can be damaging to nasal tissue.
  • Humidifiers. A humidifier adds moisture to the air, and can help reduce nasal passage dryness and relieve nasal congestion.
  • Avoid irritants that can cause breathing issues. If you have allergies as well as a deviated septum, reducing your exposure to irritants can help you breathe more freely. The best way to do this is to "allergy-proof" your home, or reduce the number of irritants around the house that can aggravate your breathing.

Remember— these options cannot correct a deviated septum— only sinus surgery can do that. However, these treatments are effective in relieving some of the symptoms caused by a deviated septum and can help open up the non-deviated nasal passage.

Breathing Problems? The Cause May Be Right Under Your Nose!

A deviated septum is a very common occurrence— most people have it in some form! However, they may not even realize they have it, since their symptoms are likely not causing any issues. But if your deviated septum is causing problems, there are ways to treat it— with or without surgery.

Not sure if you have it? Talk to an ear, nose, and throat specialist or your doctor. They can help you find the root of your breathing problems and get started with the right treatment.

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1. “Sleep Apnea: Symptoms, Risks and Treatments.”, 7 June 2022,
2. “Septoplasty.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 15 Dec. 2021,