Waking up in a pool of drool is not only uncomfortable but can be embarrassing and smell unpleasant. Frequently experiencing this may indicate a drooling problem.
We expect to see drooling in babies and toddlers who are teething and still developing muscle control. However, for adults who experience excessive drooling in sleep, several factors1 could explain this issue:
- The body produces too much saliva.
- There is not enough muscle control to contain the saliva that the body produces.
- The body is not adept at swallowing the saliva before it escapes from the mouth.
Medically, excessive drooling is referred to as “ptyalism” or “sialorrhea.”1
Below, we discuss why this might be occurring and how to mitigate the issue so you can wake up comfortably.
Causes of Drooling While Sleeping
Sleeping Position
The position you sleep in could make you more prone to excessive drooling. Sleeping on your stomach or on your side are two postures that could be contributing to more drooling.1
As your body produces saliva, the liquid is more likely to escape from the front or the side of your mouth when it’s facing downward due to mere gravity. In this case, sleeping on your back in bed is a quick way to help resolve the issue.1
Learn More: How To Properly Sleep On Your Back
Nasal Congestion
When the nasal passageways are congested, people are more likely to breathe through their mouths. Open mouths may lead to more drool2 finding its way onto your pillow.
Sleeping with your mouth open increases the amount of air that passes through your mouth. This increased air facilitates movement and can lead to an overflow of saliva out of your mouth.2
Need more info? Learn how to sleep with a cold here.
Gastrointestinal Reflux Disorder
GERD or gastrointestinal reflux disorder, is also commonly known as chronic acid reflux. The heartburn that patients experience is due to stomach acid being backed up in the esophagus3. As a result, swallowing can be difficult because the patients report that it feels like they have a lump in their throat.
One of saliva’s main purposes4 is to help you swallow, so if the body senses you’re having trouble swallowing, it will produce even more saliva to try and help, which could lead to drooling.
Medications
Some medications cause excessive saliva production5. This is most commonly seen with medications treating psychiatric disorders, Alzheimer’s disease, and Myasthenia gravis (a neuromuscular disease).
There are several reasons6 different medications will cause drooling, but usually, it has to do with their impact on the nervous system. Drugs that affect the nervous system can prevent the muscles in the mouth from holding the liquid in or swallowing it down.
Dysphagia
Dysphagia is the general term for difficulty when swallowing, and it can result from certain nervous system disorders like Bell’s palsy or Parkinson’s disease, or stroke7. These conditions can prevent muscles from functioning correctly, prohibiting the mouth from working as it should, thus allowing liquid to escape. However, the issues could be as benign as a sore throat that makes swallowing uncomfortable.
Sleep Apnea
Sleep apnea is a disorder that causes someone to stop breathing8 several times throughout the night, either due to a blockage in the airway (obstructive sleep apnea) or because of a miscommunication between the brain and the throat muscles (central sleep apnea).
One of the signs of either type of sleep apnea is excessive drooling.5
Other symptoms include snoring, waking up suddenly during the night gasping for breath, excessive daytime drowsiness, and having a sore throat or dry mouth in the morning. If sleep apnea is left untreated, it can lead to more serious health complications.8
If you feel you may have sleep apnea, talk to your doctor.
Learn More: What is a Sleep Study?, Best CPAP Machine, and Best Mattress for Sleep Apnea
Allergies and Infections
An infection, especially in the sinuses, could also cause excessive drool; this is because infections tend to produce extra saliva in the mouth as the body tries to flush out the foreign invaders attacking the immune system. In turn, if there are blocked nasal cavities, the body resorts to mouth-breathing, which allows a free flow of saliva.5
Allergies can also be an issue. For example, blocked sinuses due to allergies can lead to unwanted drainage in the form of nighttime drool.5
Related: Best Hypoallergenic Mattress
Pregnancy
Drooling is a common side effect of pregnancy, especially in the first trimester9. There are several reasons this occurs: hormonal fluctuations, increased levels of nasal congestion10, and increased nausea.9
Nausea, another known pregnancy symptom11, causes saliva production to increase, likely because the part of the brain responsible for vomiting and the part responsible for saliva production are in close proximity.1
More: Best Mattress for Pregnancy and Best Pregnancy Pillow
Other Causes of Drooling
Neurological Disorders
Neurological disorders like cerebral palsy, Parkinson’s disease, stroke, ALS (amyotrophic lateral sclerosis), MS (multiple sclerosis), Down syndrome, or autism may cause drooling.1 By definition, neurological disorders12 affect the brain as well as the nerves throughout the body, which can result in muscle dysfunction.
If this is the case, these disorders may prevent the muscles around the mouth and jaw from functioning to contain the saliva. In turn, the neurological impairment may also prevent the brain from signaling the body when it’s time to swallow.
Epiglottitis
The epiglottis is a small piece of cartilage that covers and protects our windpipe in the back of the throat. If this piece of cartilage gets infected, “epiglottitis” occurs and leads to dangerous swelling13. As a result, swallowing and breathing may become difficult, and drooling increases.
An injured epiglottitis is considered an emergency, so if you are having trouble swallowing and breathing, accompanied by excessive drool, fever, or a muffled or hoarse voice, seek emergency care.
Bell’s Palsy
Bell’s palsy14 is a neurological condition that causes sudden weakness in the muscles, usually on one side of the face.
Scientists aren’t exactly sure what causes this aside from some sort of swelling or irritation of the nerve that controls those facial muscles. It may be more likely to occur after a viral infection. People with this condition leads to facial drooping on one side. It’s usually temporary and resolves itself within months. During this time, the muscles in the face may become too weak or paralyzed, resulting in excessive saliva excretion.14
Guillain-Barre Syndrome
Guillain-Barre Syndrome15 is a serious autoimmune condition. The nerve cells become damaged or frayed because the body begins attacking them as a misguided immune response. When the nerves no longer function properly, muscle weakness and even paralysis can occur. Drooling is one of the many manifestations of this disease.
Dental Issues
Certain dental issues like an infection16 or resulting bacterial infections like Ludwig’s angina17 can lead to increased drooling. Infections of the mouth and gums can be serious, and if left untreated can even be deadly.
If your drooling is accompanied by tooth or mouth pain, bad breath, fever, swelling, neck pain, or trouble opening your mouth, you may have an infection and should seek medical treatment.16, 17
Deviated Septum
The nasal septum is the thin wall that separates your two nasal passages. When it is “deviated,” this means that this thin wall is crooked18, making one nostril harder to breathe out of than the other. For some people, this leads to breathing through the mouth during sleep, which can lead to drooling.
How to Stop and Prevent Drooling
Change Your Sleeping Position
Sleeping on your back may help curb drooling in your sleep.5 However, if you’re a die-hard side sleeper, the thought of sleeping on your back may not sound feasible. If you don’t want to change your sleeping habits, you may consider something like a wedge pillow that elevates your mouth and allows gravity to do its job.
Mouth Devices
Chin strap
A chin strap can be used to help keep your mouth closed during sleep. If an open mouth is the only reason you’re drooling at night, a chin strap may help. Oftentimes these are sold to be used with a CPAP mask, however, you can use a chin strap on its own as well.
View Our Full Guide: Best Mouth Guard for Teeth Grinding
CPAP Machine
Continuous positive airway pressure CPAP machines are used to treat sleep apnea. If the apnea is the cause of the drooling, then using this device should help. If a patient is still producing excess drool, then it’s time to explore other causes.5
Treat Allergy and Sinus Problems
Drool caused by allergies or sinus issues should be able to be alleviated by treating those issues directly. These problems could clear up on their own as the stimulants lessen or seasons change.
Alternatively, you may elect to take medication to help with symptoms.5
Talk To Your Doctor About Other Options
Medications
Medications that affect the salivary glands could help adults who struggle with drooling, and one of the most commonly prescribed medications for this is scopolamine.1 This drug is primarily used to reduce motion sickness and vomiting but is sometimes given before surgery to reduce saliva production19.
Unfortunately, research shows it comes with many side effects, so its risks may outweigh the rewards.19
Speech Therapy
If the tongue and jaw muscles aren’t experiencing a full range of motion, your doctor may recommend speech or motor therapy.1, 5 This course of treatment is also recommended for patients whose lips don’t connect when they close their mouths. This solution isn’t an overnight cure, but it could help a patient improve over time.
Botox Injections
Botox is an injectable made from the Botulinum toxin20 and is used to treat many conditions such as migraines and wrinkles. The muscles under the skin that contract create wrinkles as we age, and Botox paralyzes these.
The same principle applies to the salivary glands, so by injecting Botox into the glands, they should cease to function and stop creating saliva.1
Surgery
The last resort is to explore surgery to reduce drooling, which is only recommended when all other options have been exhausted. Most often, surgery involves clipping the salivary glands, or sometimes, the salivary ducts are rerouted to the back of the mouth.1
Complications from Drooling
Not only is drooling embarrassing, especially if it occurs during the day, but drooling can also be ultimately harmful to your body. Some of the resulting complications21 may include:
- Mouth infections
- Soiling of clothing
- Increased risk of inhaling saliva, food, or fluids
- Impaired communication
- Chapped lips or skin around the mouth
- Degradation of the skin’s surface from constant exposure to moisture
- Anxiety
Frequently Asked Questions
Is drooling normal in adults and the elderly?
While it may be common in older adults, there’s typically an explanation for the drooling.
Drooling is often due to either a neurological disorder or a side effect of a medication. For example, an adult who who is taking drugs for dementia or Parkinson’s could produce excessive drool as a result of the medication.5
Often in the case of older adults, the drooling occurs during the day as well, whether it’s due to a neurological condition or a side effect of their prescriptions. Because this can lead to challenges, drooling as an adult should be addressed immediately.
Is drooling common in babies and toddlers?
Babies and toddlers are expected to drool as they’re still gaining control of their muscles. Drooling also becomes more pronounced during teething, which typically begins between the ages of three and twelve months and continues as late as two or three years old.1
Can a sore throat cause drooling?
Yes, drooling could result from a sore throat. The issue happens because when sore throats are extremely painful, people might avoid swallowing to avoid pain. Additionally, some infections like strep throat cause the body to produce extra saliva.1
The excessive drooling could potentially lead to further complications like dehydration or a new infection.5 A numbing spray like Chloraseptic could help numb the throat for comfortable swallowing.
Rachael Gilpin
Content Writer
About Author
Rachael is a content writer for Sleep Advisor who loves combining her enthusiasm for writing and wellness.
References:
- “Drooling”. Cleveland Clinic. Last modified February 4, 2022.
- “Mouth Breathing”. Cleveland Clinic. Last modified April 11, 2022.
- “Gastroesophageal reflux disease (GERD)”. Mayo Clinic. Last modified January 4, 2023.
- “Saliva”. Cleveland Clinic. Last modified October 17, 2023.
- Berry, Paula S. “Why Am I Drooling? 4 Causes of Excessive Drooling”. Penn Medicine. 2020.
- Alhajj, Mandy., Babos, Mary. “Physiology, Salivation”. StatPearls. Last modified July 24, 2023.
- Azer, Samy A., Kanugula, Ashok Kumar., Kshirsagar, Ravi K. “Dysphagia”. StatPearls. Last modified November 18, 2023.
- Dieieva, Yuliia., Naumenko, Oleksandr. “Evaluation and Management in Patients with Obstructive Sleep Apnea”. Obstructive Sleep Apnea – New Insights in the 21st Century. 2023.
- “Excessive saliva in pregnancy”. National Childbirth Trust. Last modified March 2018.
- “Pregnancy Rhinitis: Relief for Ongoing Nasal Congestion Is Possible”. Nationwide Children’s. Last modified April 12, 2016.
- “Morning Sickness”. Cleveland Clinic. Last modified April 5, 2023.
- “Neurological Disorders”. Montana.gov. Webpage accessed March 22, 2024.
- “Epiglottitis”. Mayo Clinic. Last modified November 11, 2022.
- “Bell’s palsy”. Mayo Clinic. Last modified March 15, 2024.
- “Guillain-Barré syndrome”. Mount Sinai. Webpage accessed March 22, 2024.
- Erazo, David., Brizuela, Melina., Whetstone, David R. “Dental Infections”. StatPearls. Last modified November 13, 2023.
- “Ludwig’s Angina”. Cleveland Clinic. Last modified July 1, 2022.
- “Deviated septum”. Mayo Clinic. Last modified September 14, 2021.
- Reid, Susan M., et. al. “Anticholinergic medications for reducing drooling in children with developmental disability”. Developmental Medicine & Child Neurology. 2019.
- “Botox injections”. Mayo Clinic. Last modified March 10, 2023.
- Morgante, Francesca., et al. “The burden of sialorrhoea in chronic neurological conditions: current treatment options and the role of incobotulinumtoxinA (Xeomin®)”. Therapeutic Advances in Neurological Disorders. 2019.