WHY YOU DROOL IN YOUR SLEEP—AND HOW TO STOP IT

Medically reviewed by Amelia MacIntyre, DO

It's often normal to drool in your sleep. Even overnight, your mouth produces some saliva to protect the tissues in your mouth. That saliva can spill out of your mouth as drool when your facial muscles relax in your sleep and your mouth falls open.

However, drooling in your sleep can also be a sign of an underlying health condition that causes excessive saliva production, medically known as hypersalivation or sialorrhea. You might also have a condition that makes it difficult for you to breathe through your nose, prompting you to breathe only through your mouth. Sleep conditions, nasal congestion, and neurological conditions are some of the conditions that can lead to an overproduction of saliva or mouth breathing and, in turn, drooling while you sleep.

Making changes to how you sleep or managing underlying conditions can help you limit your drooling.

What Causes You To Drool in Your Sleep?

Often, drooling is due to something that isn't serious, like how you're sleeping. Other times, there might be a health condition that causes you to breathe with your mouth open or produce too much saliva.

Here are some of the more common reasons you might be drooling in your sleep:  

1.Sleep Position

You may notice you drool more when you sleep on your side or stomach. Thanks to gravity, side- or stomach-sleeping makes it easier for drool to escape from your mouth. 

While you sleep, your muscles typically relax. Since the muscles around your mouth are relaxed, your mouth can be relaxed enough that saliva slips out. Sleeping on your side or stomach allows for the saliva to come out the side of your mouth.

2.Nasal Congestion

Nasal congestion (rhinitis) is when your nasal passages swell and fill with excess mucus or snot, causing a stuffy nose. Nasal congestion usually gets worse when you lie down. As a result, you may start breathing out of your mouth while you sleep and start drooling. 

Nasal congestion is often a side effect of cold viruses, flu viruses, or sinus infections. If you have allergies, you might also experience nasal congestion after breathing in allergens like dust, pollen, or animal dander.

It's also possible to be congested because you're pregnant. Pregnancy nasal congestion, or pregnancy rhinitis, usually occurs in the second or third trimester. The exact cause of pregnancy rhinitis isn't fully understood, but it's likely caused by changing hormones and increased blood vessels during pregnancy.

In addition to drooling in your sleep, nasal congestion can cause a runny nose, sore throat, sinus pressure, and coughing.  

3.Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) causes stomach acid to flow back up the esophagus, which is the tube that connects your mouth and stomach. This regurgitation of stomach acid into the mouth can eventually damage the mouth tissue, teeth, and esophagus. People with GERD are more likely to experience irritated mouth tissue that leads to hypersalivation, causing them to drool more while they sleep.

GERD can also cause difficulty swallowing (dysphagia), which makes it feel like food is stuck in the throat. Excessive drooling is often a side effect of dysphasia.

Other symptoms of GERD can include:

• Burning in the middle of the chest or toward the throat (heartburn)
• Nausea
• Chronic cough
• Sour taste in the mouth

4.Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea (OSA) causes you to temporarily stop breathing while you sleep. People with OSA are more likely to start mouth breathing, which can lead to more drooling while you sleep. Mandibular advancement devices, which are mouthpieces used to help treat OSA, can also cause excessive production of saliva and, in turn, drooling while you sleep. 

Other symptoms of OSA include:  

• Loud snoring
• Loud snorts or gasps while sleeping
• Snoring interrupted by long periods of silence
• Daytime drowsiness or sleepiness
• Irritability

OSA is typically caused by narrow airways that become blocked when your throat muscles relax during sleep. People with jaw issues, large tongues, and certain mouth shapes can also experience OSA.

5.Teeth Grinding

Teeth grinding is medically referred to as bruxism. Grinding your teeth at night is known as sleep bruxism, and it can lead to excessive drooling. People who grind their teeth are more likely to breathe through their mouth, which can increase drooling while you sleep. Teeth grinding can also damage teeth, which may increase saliva production to protect the mouth from infection. 

Other symptoms of bruxism include:

• Jaw stiffness or pain
• Headaches
• Teeth sensitivity to hot or cold
• Daytime sleepiness
• Restless sleep
• Fragmented sleep from frequently waking up 

The exact cause of bruxism isn't well understood, but it's often linked to emotional stress and sleep apnea.

6.Oral Issues

Cavities can lead to drooling. You might also drool if a tooth or an area of soft tissue in the mouth is infected. Your body may produce more saliva when you have a cavity or infection in an attempt to wash away germs. The excess saliva may come out of your mouth at night as drool.

7.Neurological Conditions

The nervous system—the brain, spinal cord, and nerves—helps control body functions like breathing, mood, movement, and thinking. The nervous system also helps stimulate saliva production and swallowing. 

Neurological conditions or traumatic brain injuries often lead to difficulty swallowing and excessive saliva production. As a result, people with neurological conditions drool more during the day and night.

Common neurological conditions that cause swallowing issues and, in turn, drooling, include stroke, cerebral palsy, and Parkinson's disease.

Other symptoms of a neurological condition can include trouble speaking, moving, breathing, regulating mood, and processing memories.

8.Medications

Certain medications can cause hypersalivation as a side effect, leading to excess drooling while you sleep. Medications that can cause drooling include:

• Antidopaminergic drugs: Antipsychotic medications used to treat schizophrenia, like Clozaril (clozapine), are known to increase salivation—especially at night. 
• Direct muscarinic agonists: These medications stimulate the nervous system to treat various conditions. As a result, they also increase salivation and drooling. Medications include the urinary tract infection (UTI) medication Urecholine (bethanechol), the glaucoma and dry mouth medication Salagen (pilocarpine), and the Sjogren's syndrome medication Evoxac (cevimeline).
• Indirect muscarinic stimulants: Alzheimer's disease and dementia medications like Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine) can stimulate receptors that increase saliva flow.
• Benzodiazepines: A class of depressant drugs used to treat anxiety disorders, insomnia, and seizures can change swallowing patterns and lead to excessive drooling. These can include Xanax (alprazolam), Librium (chlordiazepoxide), and Valium (diazepam)

How To Stop Drooling in Your Sleep

How to stop your drooling depends on the underlying cause. If you're drooling because of your sleep position, you can try sleeping on your back. If you're drooling because of a medication you're taking, speak with a healthcare provider about your options, which may include switching your medication.

Other treatments that may help you stop drooling in your sleep include:

• Decongestants: Taking decongestant medications at night can help shrink and dry your nasal passages if you have a stuffy nose. This can lead to easier nasal breathing and less mouth breathing.
• Saline nasal sprays: Nasal irrigation using over-the-counter saline sprays or neti pots can help clear your sinuses and relieve stuffiness.
• Antihistamines: If you have allergies, taking antihistamines can help reduce congestion that makes you stuffy and mouth breathe at night. 
• Continuous positive airway pressure (CPAP) machines: These sleep apnea devices can help some people with OSA breathe better at night. CPAP machines cover your nose–or nose and mouth—with a mask that pumps air into your airway while you sleep. 
• Sleep apnea surgery: Severe OSA symptoms may be treated with surgery. This involves removing extra throat tissue, removing tonsils and adenoids, or correcting facial structures obstructing breathing. 
• Botox injections: Injecting Botulinum toxin (Botox) into the salivary glands can help decrease saliva production that causes excessive drooling. This is often used to treat drooling caused by cerebral palsy or Parkinson's disease. 

Tips for Preventing Drooling

If you're a frequent nighttime drooler, there are a few ways you can help prevent excessive drooling in your sleep:

• Change your sleep position: Sleeping on your back is the best way to avoid saliva leaking from your mouth while you sleep. 
• Elevate your head while sleeping: If you have nasal congestion or GERD, propping yourself up on a pillow can help you breathe better and mitigate nighttime acid reflux. 
• Drink more water: Staying hydrated can help thin mucus in your nose and sinuses, helping to relieve nasal congestion so it's easier to breathe.  
• Use a humidifier at night: Humidifiers can help increase the water in the air, relieving congestion and making breathing easier. 
• Try nasal strips: If you have trouble breathing out of your nose, adhesive nasal strips may help widen your nostrils and make breathing easier. 

Complications of Drooling in Sleep

Excess drooling in your sleep often causes people to wake up frequently during the night. This can cause poor sleep, leading to drowsiness and tiredness during the day.

Repeated lack of sleep can eventually lead to sleep deprivation, which makes it difficult for your body to function and your brain to think clearly. Sleep deprivation also increases your risk of injury and chronic health issues like heart disease, diabetes, high blood pressure (hypertension), and depression.

Drooling during your sleep can also irritate the skin around your mouth, cause a bad odor, and lead to dehydration.

While rare, hypersalivation at night can also increase your risk of choking, coughing, or suffocation. If you drool in your sleep due to GERD, you may eventually get soft tissue damage and eroded teeth. This can lead to sensitive teeth and cavities. 

When To See a Healthcare Provider

Occasional drooling while you sleep usually isn't a reason to seek medical attention. But if excessive drooling at night affects your sleep and quality of life, you should see your healthcare provider. You could have an underlying condition affecting your sleep and salivation levels.

If you are drooling while you sleep, additional symptoms that warrant a trip to your healthcare provider include:  

• Stuffy nose with facial swelling that blurs vision
• Cough that lasts for more than 10 days
• Nasal discharge after a head injury
• Fever that doesn't go away after few days
• Extreme tiredness during the day
• Gasping or periods of paused breathing during sleep
• Loud snoring that affects your or others' sleep 
• Tooth sensitivity to hot or cold
• Tooth or gum pain

A Quick Review

Drooling in your sleep is often caused by a combination of your facial muscle relaxing and saliva dribbling out of your mouth as you lie on your side or stomach. But you may drool in your sleep due to an underlying condition that causes excess saliva or difficulty breathing out of your nose. Nasal congestion, GERD, neurological conditions, teeth grinding, and obstructive sleep apnea can all lead to drooling while you sleep. If you have excessive drooling at night, try sleeping on your back or try to treat any underlying congestion. See your healthcare provider if your drooling causes sleep issues or other complications. 

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2024-03-09T17:02:14Z dg43tfdfdgfd