Waking up with a damp pillow? You’re likely experiencing what many know as sleep drooling. It might be a bit embarrassing to discover, but drooling while sleeping is actually a very common phenomenon. This moist residue is simply leftover saliva that escaped your mouth overnight. We all produce saliva continuously, even as we sleep, and sometimes, that saliva finds its way out. But Why Do I Drool When I Sleep? Understanding the reasons behind nocturnal drooling can help you determine if it’s just a normal occurrence or something that might require attention.
Is Drooling While Sleeping Normal?
In many cases, drooling during sleep is perfectly normal. Saliva production is a constant bodily function, regulated by our circadian rhythm, which is our natural sleep-wake cycle. While we generally produce more saliva during the day to aid in digestion and keep our mouths moist for speech, saliva production doesn’t simply shut off when we fall asleep. This continuous production is essential for maintaining lubrication in your mouth and throat, a crucial aspect of overall health. This natural process can sometimes lead to saliva escaping the mouth during sleep, resulting in what we know as drool. However, while often normal, excessive drooling can sometimes be associated with issues like bad breath, dehydration, and, understandably, feelings of self-consciousness.
Common Causes of Drooling During Sleep
Drooling during sleep, technically known as sialorrhea or hypersalivation when excessive saliva production is involved, happens when there’s an imbalance between saliva production, the ability to keep saliva in your mouth, and the swallowing reflex. While occasional drooling is usually not a cause for concern, several factors can contribute to increased drooling while you sleep.
Your Sleeping Position
Your sleep position plays a significant role in whether or not 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 and naturally flow down your throat. However, for side sleepers and stomach sleepers, gravity takes a different turn. In these positions, saliva is more likely to be pulled downwards and out of your mouth, ending up on your pillow.
If you are a side or stomach sleeper who tends to sleep with their mouth open, you are even more prone to drooling. This is simply because an open mouth provides an easy exit for saliva. Switching to sleeping on your back can be a simple yet effective way to minimize drooling. Additionally, consciously trying to breathe through your nose and keep your mouth closed during sleep, perhaps with the aid of mouth tape, can also help.
Person stretching in bed, representing waking up, potentially with drool.
Infections and Allergies
Experiencing a cold, strep throat, or seasonal allergies can significantly increase drooling. These conditions often lead to inflammation in your sinuses and nasal passages, causing nasal congestion and making it harder to breathe through your nose. As a result, you may resort to mouth breathing, which, as mentioned earlier, increases the likelihood of drooling. Other infections such as mononucleosis, tonsillitis, and sinus infections can also contribute to increased saliva production and subsequent drooling.
Gastroesophageal Reflux Disease (GERD)
While heartburn is the most recognized symptom of gastroesophageal reflux disease (GERD), drooling and dysphagia, or difficulty swallowing, are also common indicators. GERD occurs when stomach acid frequently flows back up into the esophagus, irritating its lining. Dysphagia associated with GERD can create a sensation of a lump in the throat, which can inadvertently increase saliva production and drooling. Furthermore, when the esophagus is irritated or obstructed, the body may naturally produce more saliva in an attempt to soothe and relieve the irritation, leading to increased drooling as a consequence.
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repeated pauses or shallow breaths during sleep. Mouth breathing is frequently associated with OSA, and can even exacerbate the condition. Sleeping with your mouth open due to OSA significantly increases the chances of drooling, as the saliva has an easier path to escape. If you suspect you might have OSA, look out for other symptoms such as:
- Snoring, gasping, or choking sounds during sleep
- Frequent awakenings during the night
- Morning headaches
- Difficulty concentrating during the day
- Excessive daytime sleepiness
Bruxism
Drooling often accompanies sleep bruxism, commonly known as teeth grinding during sleep. This connection could be due to the link between bruxism and mouth breathing. Similar to OSA, individuals who grind their teeth at night are more likely to breathe through their mouth, creating an opening for saliva to escape. Besides drooling and mouth breathing, other risk factors for bruxism include snoring, restlessness during sleep, and shorter sleep duration.
Medication Side Effects
If you are taking prescription medications and notice increased drooling at night, 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 prescribed for Alzheimer’s disease. It is important to note that if drooling is listed as a potential side effect of your medication, you should not stop taking the medication without consulting your doctor first. Instead, discuss your concerns with your healthcare provider and ask if they can recommend an alternative medication that is less likely to cause drooling.
Underlying Medical Conditions
Your nervous system plays a crucial role in stimulating your salivary glands. This neurological connection explains why impaired swallowing and excessive drooling are common symptoms associated with neurodegenerative disorders. For instance, approximately 70% of individuals with Parkinson’s disease and up to 80% of people with cerebral palsy experience excessive salivation. Difficulty swallowing and increased drooling can also arise from other medical conditions, including:
- Epiglottitis
- Bell’s palsy
- Amyotrophic lateral sclerosis (ALS)
- Huntington’s disease
- Stroke
- Traumatic brain injury
How to Stop Drooling While Sleeping
Occasional drooling during sleep is generally considered normal and may not require any specific treatment. However, if you feel you are drooling excessively or it’s becoming bothersome, there are various strategies you can try to reduce or stop drooling while you sleep. These range from simple lifestyle adjustments to medical interventions like speech therapy, medication, and in rare cases, surgery. Some solutions are straightforward, while others are reserved for more severe cases. Consulting with your doctor is recommended to determine the best approach for your specific situation.
Change Sleeping Positions
The simplest and often most effective first step to address drooling is to change your sleep position. If you are primarily a side or stomach sleeper, consciously try to transition to sleeping on your back.
Keep in mind that changing sleep positions may also necessitate adjusting your pillow. Side sleepers typically require a thicker pillow than back sleepers, while stomach sleepers often prefer a very thin pillow or no pillow at all. If you find it challenging to stay on your back throughout the night, using additional pillows placed along your sides can help maintain your position.
Treat Allergies
If you experience nighttime drooling and also suffer from allergies, addressing your allergies might be the solution. Effective allergy treatment can help clear up your sinuses and nasal passages, encouraging nasal breathing instead of mouth breathing. If you can comfortably breathe through your nose while sleeping, you are likely to experience a reduction in drooling.
Consider Botox Injections
Botulinum toxin injections, commonly known as Botox, are considered a safe and effective treatment option for excessive drooling, particularly due to their minimal side effects. Injecting Botox into your salivary glands can temporarily reduce their saliva production. However, it’s important to remember that Botox injections are not a permanent fix. The effects typically wear off after a few months, requiring repeat injections to maintain the reduced drooling.
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 by gently repositioning the jaw to keep the lips closed and the tongue and teeth properly aligned.
Try Speech Therapy
Speech therapy can be beneficial in addressing drooling through targeted exercises that strengthen the muscles of your tongue and jaw, improving their coordination and stability. With improved muscle control, you may be able to swallow more effectively, maintain a closed mouth posture more easily, and ultimately reduce drooling.
Ask About Medications
For individuals with neurological conditions that cause excessive drooling, certain medications may be prescribed. These medications work by blocking nerve signals to the salivary glands, thereby reducing saliva production. However, it’s important to be aware that these medications often come with side effects, the most common being an overly dry mouth.
Ask About Surgery
In severe cases of hypersalivation that are unresponsive to other treatments, surgery may be considered. Several surgical procedures are available to treat drooling, including surgical removal of some salivary glands, rerouting salivary gland ducts, and reducing nerve connections to the salivary glands. Surgery is generally reserved for individuals who experience significant drooling even during waking hours and is considered a last resort after other less invasive options have been explored and proven ineffective. Studies suggest that surgery for drooling can be quite successful, with reported improvement rates as high as 89%.
When to Talk to Your Doctor
Occasional drooling during sleep is usually not a cause for concern. However, if you are consistently worried about excessive drooling, it’s advisable to schedule an appointment with your healthcare provider. They can assess your situation, determine if your drooling could be a symptom of an underlying health condition, and provide personalized recommendations on how to manage and reduce drooling during sleep.
