Waking up with a damp pillow can be an unpleasant and slightly embarrassing start to your day. That wet patch is drool, the result of excess saliva escaping your mouth while you were asleep. Everyone produces saliva, even during sleep, and occasionally, some of it may dribble out. But why do some people drool more than others, and when should you be concerned?
Is Drooling During Sleep Normal?
In many cases, drooling during sleep is perfectly normal. Saliva plays a vital role in keeping our mouths and throats lubricated, which is essential for overall health. Our bodies produce saliva throughout the day and night, potentially following a circadian rhythm, with production generally decreasing at night but continuing nonetheless. This natural saliva production during sleep can sometimes lead to drooling. While occasional drooling is usually not a cause for concern, it’s understandable to wonder if your nighttime drooling is excessive or indicative of an underlying issue.
Is Your Drooling a Problem?
Drooling during sleep is sometimes associated with conditions like sleep apnea. If you’re concerned about your drooling, reflecting on a few key questions can help determine if further evaluation is needed.
Why Do I Drool in My Sleep?
Drooling, also known medically as sialorrhea or hypersalivation when excessive saliva production is involved, happens when you produce more saliva than you can comfortably manage in your mouth, have difficulty keeping saliva inside your mouth, or experience impaired swallowing. While some drooling during sleep is considered normal, several factors can contribute to increased drooling.
Your Sleeping Position
Person stretching in bed, representing different sleep positions
Your sleep position significantly impacts whether you wake up to a drool-soaked pillow. When you sleep on your back, gravity works in your favor, allowing any excess saliva to remain in your mouth or flow down your throat. However, if you are a side or stomach sleeper, gravity encourages saliva to escape your mouth and onto your pillow.
Side and stomach sleepers who also tend to sleep with their mouths open are even more prone to drooling. Choosing to sleep on your back could be a simple yet effective way to minimize nighttime drooling. Additionally, consciously trying to breathe through your nose and keep your mouth closed while sleeping, perhaps with the aid of mouth tape, might also help.
Infections and Allergies
Experiencing a cold, strep throat, or seasonal allergies can lead to increased drooling. These conditions often cause inflammation in your sinuses and nasal passages, making it harder to breathe through your nose. As a result, you may resort to mouth breathing, which increases the likelihood of drooling. Other infections such as mononucleosis, tonsillitis, and sinus infections can similarly contribute to increased saliva production and drooling.
Gastroesophageal Reflux Disease (GERD)
While heartburn is the hallmark symptom of GERD, drooling and dysphagia (difficulty swallowing) are also common indicators. GERD occurs when stomach acid frequently flows back into the esophagus, irritating its lining. Dysphagia associated with GERD can create a sensation of a lump in the throat, potentially leading to increased drooling. Furthermore, irritation or obstruction in the esophagus can trigger your body to produce more saliva as a way to soothe the discomfort, paradoxically resulting in more drooling.
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea (OSA) is a sleep disorder characterized by repeated pauses in breathing throughout the night. Mouth breathing is frequently associated with and can even worsen OSA. Sleeping with your mouth open due to OSA makes drooling more likely, as there’s nothing to contain saliva from escaping. If you experience symptoms such as loud snoring, gasping or choking during sleep, nighttime awakenings, morning headaches, difficulty concentrating, and excessive daytime sleepiness, it’s important to consult your doctor to rule out OSA.
Bruxism
Sleep bruxism, or teeth grinding during sleep, is often accompanied by drooling. This connection may stem from the fact that bruxism is often linked to mouth breathing. When the mouth is open during sleep due to teeth grinding, saliva is more likely to escape. Besides drooling and mouth breathing, other common factors associated with bruxism include snoring, restlessness during sleep, and shorter sleep duration.
Medication Side Effects
If you’ve noticed increased drooling at night and are taking prescription medications, it’s worth considering if your medication could be a contributing factor. Excessive salivation and drooling are known side effects of certain medications, including some antibiotics, antipsychotic drugs, and medications used to treat Alzheimer’s disease. If drooling is listed as a potential side effect of a medication you are taking, it’s crucial not to discontinue the medication without first consulting your doctor. Discuss your concerns with them; they may be able to suggest an alternative medication that minimizes drooling.
Underlying Medical Conditions
The nervous system plays a crucial role in stimulating our salivary glands. This neurological connection helps explain why impaired swallowing and excessive drooling are frequently observed in individuals with neurodegenerative disorders. For instance, approximately 70% of people with Parkinson’s disease and as many as 80% of individuals with cerebral palsy experience excessive salivation. Difficulty swallowing and increased drooling can also occur in conditions such as:
- Epiglottitis (inflammation of the epiglottis)
- Bell’s palsy (sudden weakness in facial muscles)
- Amyotrophic lateral sclerosis (ALS)
- Huntington’s disease
- Stroke
- Traumatic brain injury
How to Stop Drooling in Your Sleep
Occasional drooling during sleep is generally normal and doesn’t necessarily require treatment. However, if you believe you drool excessively and it’s bothersome, there are various strategies you can explore to reduce or stop nighttime drooling. These range from simple lifestyle adjustments to speech therapy, medications, and in rare cases, surgery. Some solutions are straightforward, while others are reserved for more severe drooling. Consulting with your doctor is the best first step to determine the most appropriate approach for you.
Change Sleeping Positions
The simplest step you can take to address drooling is to alter your sleep position. If you are a side or stomach sleeper, try transitioning to sleeping on your back.
Keep in mind that changing sleep positions may necessitate adjusting your pillow. Side sleepers typically require thicker pillows compared to back sleepers, while stomach sleepers often prefer very thin pillows or no pillow at all. If you find it challenging to remain on your back throughout the night, using extra pillows to prop yourself on either side can help maintain the position.
Treat Allergies
If nighttime drooling is accompanied by allergies, addressing your allergies might be the key to reducing drooling. Effective allergy treatment can help clear your sinuses and promote nasal breathing. By breathing through your nose instead of your mouth during sleep, you can significantly decrease drooling.
Consider Botox Injections
Botulinum toxin injections, commonly known as Botox, are considered a safe and effective treatment option for excessive drooling with minimal side effects. Injecting Botox into the salivary glands can temporarily reduce saliva production by blocking nerve signals. However, Botox injections are not a permanent solution, and repeat injections are needed every few months as the effects wear off.
Wear a Mandibular Device
Mandibular devices are oral appliances worn in the mouth during sleep. They are designed to help reduce drooling, snoring, and teeth grinding. These devices work by gently repositioning the lower jaw forward, which helps keep the lips closed and properly positions the tongue and teeth.
Try Speech Therapy
Speech therapists can provide exercises to strengthen the muscles of your tongue and jaw, improving their coordination and stability. Through targeted speech therapy, you may enhance your swallowing ability, improve mouth closure during sleep, and ultimately reduce drooling.
Ask About Medications
For individuals with neurological conditions that cause excessive drooling, doctors may prescribe medications to help manage the symptom. These medications work by blocking nerve impulses to the salivary glands, thereby reducing saliva production. However, it’s important to be aware that these medications can commonly cause side effects, such as an uncomfortably dry mouth.
Ask About Surgery
In severe cases of hypersalivation that are unresponsive to other treatments, surgery might be considered. Several surgical procedures are used to treat drooling, including surgical removal of salivary glands, rerouting salivary gland ducts, and reducing nerve connections to the salivary glands. Surgery is typically reserved for individuals who experience significant drooling even during waking hours and is considered a last resort after other less invasive options have been exhausted. Studies suggest that surgery for drooling can be effective, with reported improvement rates as high as 89%.
When to Talk to Your Doctor
Occasional drooling in your sleep is usually not a cause for concern. However, if you are worried about excessive drooling, or if it’s a new symptom, it’s advisable to schedule an appointment with your healthcare provider. They can evaluate whether your drooling could be a sign of an underlying medical condition and provide personalized recommendations on how to manage and reduce drooling during sleep.
