Cracking the Sleep Code

Is it sleep apnea or a nose problem?

Turbinate Enlargement (Hypertrophy)

It would be great if we could plug ourselves in to a sleep machine and unplug it 8 hours later.  Maybe in 100 years scientists will come out with "the sleep machine."  Unfortunately many of us have to claw, scrape and fight our way to the land of dreaming.  Breathing seems to be a common word used when there is talk of sleep issues and the word "snoring" has become a buzz word for possible sleep apnea diagnosis.

Even though rare, there have been people who have found that their sleep breathing/problems were not created by obstuctive sleep apnea as originally thought. If you have problems with your sleep and have chronic nasal congestion in one side or both sides of your nose then this article might be for you. Even if the congestion is only at night, visiting an otolaryngologist will allow you to find all possible causes.  The great thing about finding the problem in your nose is that most often is that it can be cured with minor surgery---no CPAP (continuous positive airway pressure), no soft palate surgery and no sleep studies are needed.  Advanced Ear, nose & throat Associates, PC in Atlanta GA gives this description...

Sleepless? It could be your nose.

Nasal Valve Collapse or Stenosis

Please take note if you have any trouble moving air through your nose and are or have been in either of these scenarios...

1.  You wake up frequently and are struggling for a good nights sleep
2.  You have already been through a sleep study and have a CPAP
     machine or dental device but are still struggling for adequate sleep

If a part of your nose is causing decreased airflow this could be the cause of your sleeping issues.  The good news is that there is a cure to this problem.  There are three main areas of the nose that could be at fault.

1. Dysfunctional Turbinates- (Swollen Sinuses)
2. Deviated Septum- (Crooked Septum)
3. Nasal valve collapse- (Collapse of the supporting tissue
    just above the inside of the nostril)

Some people find that they have a combination of these problems causing their sleep disruptions, other just have one. There can be a domino effect as nasal valve collapse can be caused by dysfunctional turbinates or a deviated septum. This description from Dr. Andrew Golde at  AdvancedENTPC.com explains it best...

 

Can't sleep? It could be your nose

 

Deviated Septum (Crooked Septum)

Insomnia can be caused by any prolonged disruption to your sleep. This could be caused by 'internal' factors i.e. depression/anxiety, illnesses, pain and breathing disorders.  The other 'external' causes that disrupt sleep could be children, pets, or a bed partner.  Basically anything that wakes you up on a consistent basis can snowball into a poor sleep pattern over time... causing insomnia.

If you wake up often in the night and it's not because of a full bladder, you might want to consider your breathing to be the problem.  This doesn't have to mean that you have sleep apnea or that the problem is in your soft palate at the back of the throat, although nasal problems can mask as obstructive sleep apnea.

Many people with a deviatied septum seem to get used to the lack of airflow but after a repair they figure out what they were missing. Not getting enough oxygen during sleep results in frequent arousals which translates into poor sleep.  The daytime symptom of being tired and miserable can be a common denominator between obstructive sleep apnea and a deviated septum.

If your sinuses consistently become swollen when you lay down you might want to consider this as a probable cause for your sleep disturbances.   A visit to the otolaryngologist will help determine if your septum or another part of your nose is dysfunctional.    

What is the septum?

 The septum is the center part of the nose which divides the nose into two nostrils. An injury is usually the cause of a deviated septum.  If there is even a small injury as a child there can be a deviated septum ---this small curve can then become a large curve as the child grows.  You can't always see or feel a deviated septum because it's most often too far back in the nose.  There is blockage of airflow to either one or both sides but it usually alternates. Other symptoms are nose bleeds, post nasal drainage and sinus infections.

What is done for a deviated septum?

The surgery performed for deviated septum is called a septoplasty.  It is normally done under general anesthesia but can be done under local anesthesia.  It is done in outpatient and you usually can be released within a couple hours after surgery.  A small incision is made inside the nose and the bone and cartlage are straightened.  There is minimal bruising and no cast to be worn but sometimes a splint is placed on either side to help keep the nose straight during healing---removal is about a week after surgery.  Most patients need a few days off work and are back to normal activity in about 2 weeks.

If the septum is the problem then you should feel a big difference in your breathing and sleeping after a septoplasty. The nasal valves and the turbinates are other parts of the nose to be discussed in articles  ahead...

Read about Stephen who thought for years he had sleep apnea only to find out that it was his nose that caused his sleep disordered breathing.