Deviated septum: symptoms, nighttime effects and when to see an ENT

A deviated septum means the thin wall of bone and cartilage that divides the inside of your nose is crooked. Most people have a mild one and never notice it. When it does cause problems, the usual sign is a nose that feels blocked, often on one side, and that blockage tends to show up at night as snoring, noisy breathing or poor sleep.

What is a deviated septum?

The septum is the wall between your two nostrils. ENT UK explains that a bent septum can make the inside of the nose narrower, often on one side, so that the nose feels blocked.

Some people are born with a crooked septum. Healthdirect says this is common and usually happens as the nose forms before birth. Others get one after an injury to the nose, from an accident, a sports injury or a fall. Healthdirect suggests wearing protective gear such as a helmet or face guard for sports where your nose could take a knock.

What are the symptoms?

Healthdirect Australia lists these possible symptoms:

• Difficulty breathing through your nose
• A blocked nose, on one side or alternating between sides
• Nosebleeds
• Frequent sinus infections
• Headaches or facial pain
• Snoring and noisy breathing during sleep
• Trouble sleeping
• Obstructive sleep apnoea

Many of these have other causes too. A blocked nose can also come from allergies, infections, nasal polyps or overusing decongestant sprays, which is why a doctor will check for those as well.

If your blocked side switches back and forth over the day, read about the nasal cycle before assuming the worst.

Can a deviated septum cause other problems?

When the deviation is severe or the symptoms go on for a long time, Healthdirect lists some knock-on effects. Sinus infections can become more frequent or last longer. Your sense of smell can drop if air doesn't flow properly through the nose. And ongoing blockage with poor sleep may lead to anxiety, depression and a lower quality of life.

A 2025 systematic review of mouth taping also names a deviated septum among the most common causes of mouth breathing. If you often wake with a parched mouth, our guide to waking up with a dry mouth covers that side of things.

How can it affect your nights?

Healthdirect notes that if your nose feels blocked or stuffy much of the time, it can affect your sleep, your energy and how well you feel during the day.

If your nose feels blocked at night, you may find yourself breathing through your mouth. Our guide on why you breathe through your mouth at night covers the other common reasons.

Snoring with gasping, choking or pauses in breathing is different from ordinary snoring. It can be a sign of sleep apnea, and it needs a doctor, not a home fix.

Do you have to do anything about it?

A deviated septum doesn't necessarily need treatment. ENT UK is reassuring on this point. It says many people with a twisted septum have no blockage symptoms, and that a bent septum won't do you any harm, so you can leave it alone if you want to. Only you can decide whether the effect on your breathing, sleep or exercise is bad enough to want treatment.

Healthdirect agrees that mild deviations often don't need treatment. Surgery is usually reserved for more severe deviations that cause symptoms that don't get better with medicines.

Does septoplasty work, and what are the side effects?

The clearest evidence comes from a 2023 UK trial published in the BMJ. It enrolled 378 adults at 17 NHS ear, nose and throat clinics, all with nasal blockage linked to a deviated septum and at least moderate symptoms. Half were assigned to septoplasty, the surgery that straightens the septum. The other half used a nasal steroid spray and a saline spray for six months.

At six months, the septoplasty group's symptom scores were 20 points better on a standard 22-item symptom questionnaire. The trial defined 9 points as the smallest clinically important difference. People with worse symptoms at the start improved the most. Their measured nasal airflow and quality of life also improved more.

Surgery had downsides. Seven people (4% of the 174 who had septoplasty) were readmitted to hospital with bleeding, and 20 (12%) needed antibiotics for infections. ENT UK says full recovery takes about three months, and roughly one in ten people need repeat surgery.

This trial was in people referred to specialists with at least moderate symptoms. It doesn't mean everyone with a crooked septum needs an operation.

What can help without surgery?

Healthdirect lists antihistamine nasal sprays, corticosteroid nasal sprays and saline solutions as treatment options, and is clear that none of them reshape the septum. ENT UK says steroid sprays or drops can bring down swelling inside the nose, which might improve blockage, but they need to be used on an ongoing basis.

Healthdirect also has some everyday tips for managing symptoms:

• Talk to your doctor about nasal sprays or a nasal rinse to help clear your nose. Our guide to using a saline rinse covers how to do it safely.
• Avoid things that set off your symptoms, such as cigarette smoke, strong smells or pet dander.
• Raise your head when you sleep to help with stuffiness at night.

Can nasal strips help at night?

For a lot of people, nasal strips are the easiest thing to try. A 2016 meta-analysis found that nasal dilators improve nasal breathing. The authors also point out how sensitive airflow is to small changes in size. They cite research showing that when the cross-sectional area of the nasal cavity increases by 10%, nasal airflow rises by about 21%. In a nose that's already narrowed on one side, a modest bit of extra space can feel like a lot.

The same meta-analysis found they didn't improve sleep apnea outcomes, so they're a comfort tool rather than a treatment. Whether a strip helps you depends on where the narrowing is, which we cover in nasal strips and a deviated septum. How to apply nasal strips covers getting the placement right.

What about mouth tape?

Whether mouth tape suits you with a deviated septum depends on your nose. Plenty of people with a mild deviation breathe comfortably through their nose, and if that's you, mouth tape can be a practical way to stop your mouth falling open at night. You can also pair the two, with a strip to ease airflow and tape to keep your lips closed. Mouth tape vs. nasal strips explains how the two compare.

If your nose is significantly blocked, don't use it. A 2025 systematic review of mouth taping lists asphyxiation as a potential risk when the nose is obstructed, and many of the studies it looked at excluded people with nasal blockage. Try our two-minute nose test first. If you can't breathe comfortably through your nose with your mouth closed, the septum is a conversation for your doctor before tape is.

What is recovery from septoplasty like?

If you and your surgeon decide on surgery, ENT UK's patient leaflet gives a good picture of what to expect. The operation is done under general anaesthetic through small cuts inside the nose, so there are no scars on the face. It isn't meant to change how your nose looks, and most septoplasties are day cases.

Your nose may be packed with dressings for a few hours or overnight, and a small plastic splint may be left inside for seven to ten days. While the packing and swelling block your nose, you'll breathe through your mouth, which ENT UK says will make your mouth feel dry, so keep water nearby.

ENT UK's aftercare advice includes:

• Taking two weeks off work, especially if your job is dusty or involves heavy lifting.
• Avoiding strenuous exercise for two weeks and contact sports for a couple of months while the nose is weak.
• Not blowing your nose for at least two days after you get home, then blowing gently.
• Not flying for 14 days.
• Staying away from smoky places, since smoke irritates the nose and delays healing.

It can take up to three months for your nose to settle and your breathing to become clearer. Once it has, it's worth retaking the nose test to see how things have changed.

When should you see an ENT?

Healthdirect advises seeing a doctor if you think a deviated septum is causing you problems, or if symptoms continue after treatment. In practice, that includes a nose that's blocked most days for weeks, frequent nosebleeds or sinus infections, or sleep that's being disrupted. A GP or family doctor is a reasonable first stop, and can refer you to an ear, nose and throat specialist.

A doctor will usually look inside the nose with a light and instruments, or a small camera called a nasal endoscope. They'll also check for other causes of blockage, such as allergies, infections, nasal polyps, overuse of nasal sprays or a nasal tumour. If decongestant sprays have become a habit, read decongestant spray rebound before your appointment.

See a doctor promptly if you snore loudly and gasp, choke or stop breathing in your sleep, or if you're exhausted during the day despite a full night in bed.

If you want to try nasal strips, our pick is TitanAir Nasal Strips.

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.