How to sleep with a deviated septum

Sleeping with a deviated septum usually gets easier when you work on the parts of the blockage you can change. The bend itself stays put without surgery, but swelling, dryness and the way you lie all add to it, and those you can do something about. Most people find a combination works best: a side position with the head slightly raised, a saline rinse before bed, a steroid spray if a clinician suggests one, and a nasal strip to open the front of the nose.

Why is sleeping harder with a deviated septum?

A deviated septum makes sleep harder because it narrows the inside of the nose, often more on one side. ENT UK describes the septum as the thin wall of cartilage and bone between your nostrils, and says a twisted or bent septum can make the nose narrower and feel blocked.

Cleveland Clinic lists difficulty breathing through the nostrils (usually worse on one side), nasal congestion, noisy breathing and snoring among the symptoms, and says a severe deviation can cause dry mouth. When your nose can't carry enough air at night, your mouth tends to fall open, and that's when snoring and a parched morning mouth show up.

Plenty of people have a bent septum and never notice it. Cleveland Clinic says most people don't need treatment because they have few or no symptoms, and ENT UK says many patients with a twisted septum have no blockage at all. If you're not sure the septum is the cause, our guide to deviated septum symptoms can help you sort it out.

What is the best sleeping position for a deviated septum?

The best sleeping position for a deviated septum is usually on your side, with the more blocked nostril facing up and your head a little raised. Gravity is the reason. Lying down makes the soft lining of the nose swell, and on your side the swelling is greatest on the lower side.

A 2024 study measured this in 60 adults, half with allergic rhinitis and half without. Lying on your back or side narrowed the tightest part of the nasal passage compared with sitting up. On the side, the turbinates (the soft ridges inside the nose) swelled on the lower side. Healthy volunteers felt more blocked lying down, and in both groups measured airflow was better in more upright positions.

The study didn't include people with a deviated septum, so nobody has tested this exact advice. Still, the logic is simple. If your septum already narrows the left side, lying on your left side adds swelling to the narrow side. Rolling onto your right side keeps the tight side on top. Try both sides for a few nights and notice which lets you breathe through your nose more easily. An extra pillow or a wedge to lift your head is worth trying too.

Does a saline rinse help at night?

A saline rinse before bed can clear mucus and irritants so the narrower side has less in the way. It doesn't change the septum, but it's gentle enough to use every night.

Water safety is the one rule that matters. The FDA says to rinse only with distilled, sterile or previously boiled water. Tap water isn't safe for nasal rinsing because it can contain low levels of organisms, including amoebas, that stomach acid would kill but that can survive in the nose and cause serious infections. If you boil tap water, the FDA says to boil it for 3 to 5 minutes, cool it until lukewarm, and use it within 24 hours. Our step-by-step guide to how to use a saline rinse covers technique.

Should you try a steroid nasal spray?

A steroid nasal spray is worth asking a clinician or pharmacist about if your nose feels blocked most nights. ENT UK says steroid spray or drops can bring down swelling of the inside walls of the nose, which might improve blockage symptoms. Cleveland Clinic lists nasal steroid sprays, antihistamines and decongestants among the over-the-counter options for mild symptoms.

Two cautions. First, decongestant sprays are a short-term tool: Cleveland Clinic says not to use them for more than three days in a row. Our article on decongestant spray rebound explains what happens if you do. Second, steroid sprays work on swelling, not on cartilage. In a 2023 trial in the BMJ, 378 adults with nasal blockage and a deviated septum got either septoplasty or six months of steroid spray plus saline spray. At six months, the surgery group's symptom scores were about 20 points better on a 110-point scale. So if sprays help you, that's great, and if they don't, that doesn't mean nothing will.

Does a humidifier help?

A humidifier can make a narrow nose feel less dry and crusty overnight, which matters more when one side is already tight. Keep it within sensible limits. The EPA advises against humidifying a home above 50% relative humidity, because higher levels may encourage the growth of biological organisms in the home, and suggests using a hygrometer to check.

The EPA also recommends distilled or low-mineral water and cleaning portable humidifiers every third day. Our article on using a humidifier for sleep goes into which type to choose.

Do nasal strips and dilators help with a deviated septum?

Nasal strips and dilators can help, especially when the bend is near the front of the nose. A strip lifts the sides of the nose outward and widens the nasal valve, the narrowest part of the airway just inside the nostrils.

A 1998 study in the Laryngoscope tested an external nasal dilator in people with blockage from swollen nasal lining, people with a deviated septum in the nasal valve area, and people with healthy noses. The dilator widened the narrowest part of the nose and lowered nasal resistance in all three groups, and the effect was larger in the deviated septum group. The authors called it an effective non-surgical approach when the deviation blocks the nasal valve.

Other research backs strips for night use more broadly. In a 2018 randomized, double-blind trial, a strip beat a placebo strip without springs on some sleep and symptom measures in people with chronic nighttime congestion. A 2016 meta-analysis found nasal dilators improve nasal breathing but don't improve sleep apnea, so a strip isn't a substitute for a sleep study if you have warning signs.

The limit is anatomy. A strip can't straighten the septum or reach a bend further back in the nose. If a strip gives you a clear lift, the front of the nose is likely part of the problem. If it does nothing, the narrowing may be deeper. Our article on nasal strips and a deviated septum goes into placement and what to expect, and how to use a nasal dilator covers the internal type that sits inside the nostrils.

Can you use mouth tape with a deviated septum?

You can use mouth tape with a deviated septum only if you can breathe comfortably through your nose with your lips closed. Test it during the day first, and try a strip on its own before adding tape. If one side is badly blocked, or your nose closes up when you lie down, skip the tape until the blockage is sorted. We don't recommend mouth tape for children.

When is surgery for a deviated septum considered?

Surgery is usually considered when the blockage keeps affecting your breathing, sleep or exercise even after sprays and other steps. Cleveland Clinic says septoplasty, which reshapes the septum, is the only way to fix a deviated septum, and suggests talking to a provider if symptoms interfere with breathing or disrupt your sleep. ENT UK says a bent septum won't do you any harm, so leaving it alone is also a fair choice, and only you can decide whether the effect on your breathing, sleep or exercise is bad enough to want more treatment.

The 2023 BMJ trial gives the clearest picture of what surgery can offer. Septoplasty beat steroid and saline sprays on symptom scores, quality of life and measured airflow. It isn't risk-free: 4% of the people who had surgery were readmitted to hospital with bleeding. ENT UK notes that surgery doesn't always improve symptoms and that most people take about two weeks off work to recover.

An ENT specialist can look inside your nose and tell you where the narrowing is, which also tells you how much a strip or a spray is likely to help. Our guide to nose surgery for breathing covers septoplasty, turbinate reduction and nasal valve repair, and our article on deviated septum and sleep apnea explains when a sleep study makes sense.

Our pick (paid partner): TitanAir Nasal Strips

If you want to add a strip to your night routine, our pick is TitanAir Nasal Strips from Titan Recovery. This is our recommendation, not the result of testing or ranking products ourselves.

Titan says TitanAir strips are drug-free external nasal dilators with flexible spring-loaded bands. Place one just above the flare of your nostrils on the soft part of the nose, not the bony bridge, on clean, dry skin with no moisturizer. In the morning, Titan says to loosen it with warm water and peel it slowly from the ends inward. The strips come with a 30-night guarantee, which is a fair window to see how they work alongside your other steps.

Read next

• Deviated septum symptoms
• Nasal strips and a deviated septum
• Nose surgery for breathing

* 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.