Nasal Surgery and CPAP: Is Your Nose the Issue?

If you use CPAP and it feels like a wind tunnel, I want you to ask one question:

Is the real problem your nose?

When your nose is narrow, congested, or just never really open, CPAP has to work a lot harder. That can show up as mouth breathing, big mouth leaks, dry mouth, and machines that keep cranking the pressure up to try to push air through a tiny opening.

So let’s talk about where nasal surgery fits into this picture.

Inside your nose there are two key players:

• the septum, the wall down the middle that can be crooked or deviated, and
• the turbinates, soft ridges along the side that warm and humidify the air but can become chronically swollen.

Some people have temporary congestion from allergies or colds. Others have a more fixed blockage — a badly deviated septum or enlarged turbinates that make one or both sides feel plugged almost all the time. That’s when ENTs may talk about septoplasty and turbinate reduction.

Septoplasty straightens the septum to open the central passage. Turbinate reduction gently shrinks the swollen tissue along the side walls. These are usually outpatient procedures with the main goal of improving nasal airflow so you can simply breathe through your nose more easily.

So here’s the key question:

Does nasal surgery cure sleep apnea?

For most people with moderate or severe OSA, the honest answer is no. Nasal surgery by itself usually does not fully treat sleep apnea. There are exceptions — some folks with primary snoring or very mild OSA may get a substantial improvement, but that’s not something I’d ever promise as the main plan.

Where nasal surgery really shines is as a team player with CPAP or dental devices.

Studies show that in people with nasal obstruction, nasal surgery can:

• lower the CPAP pressure you need,
• make the airflow feel smoother and more comfortable, and
• help you use your CPAP longer and more consistently each night.

That’s a big deal, because comfort and pressure tolerance are often the real barriers to success.

You’ve probably heard me say this before, but I am a big fan of nasal breathing. My preferred setup, when it’s possible, is:

• a nasal mask or nasal pillows,
• plus good nasal care — saline, allergy treatment, anti-inflammatory sprays when needed,
• and then something to control mouth leaks so the nose can actually do its job.

That’s exactly why I developed SomnoSeal — to give mouth-breathers a way to keep a nice sealed nasal circuit and avoid that miserable dry mouth without a bulky chinstrap.

If, after all of that, you still feel like you cannot breathe through your nose, or you’re stuck on very high pressures and can only tolerate a full-face mask, that’s when I start thinking about an ENT evaluation. Especially if you’ve always felt blocked on one side, have a history of nasal trauma, or your provider sees clear structural issues.

If you and your ENT decide on surgery, I want you to go in with realistic expectations:

• It may not magically normalize your apnea numbers.
• But if it gives you an open nose, lowers your pressure, and makes it easier to stick with CPAP or an oral appliance, that’s a huge win for your long-term health.

So the takeaway is this:

Nasal surgery is usually not a cure for sleep apnea on its own. But for the right person with a chronically blocked nose, it can be a powerful way to make CPAP — or your oral appliance — more comfortable, more effective, and more sustainable.

If you’re struggling with CPAP because of your nose, talk with your sleep doctor about whether an ENT evaluation makes sense for you. And if you’re working on mouth leaks or dry mouth, remember there are non-surgical tools — including SomnoSeal — that can help you get back to comfortable nasal breathing.

As always, my goal is to help you find a setup that you can actually live with, night after night.

Thanks for being here, I’ll see you next week!