Why Do I Drool When I Sleep?

Drooling in your sleep can have a number of causes. In general, when you sleep, the muscles in your face and body relax. Your mouth may fall open causing excess saliva to run out. Sleep position can affect whether or not you drool in your sleep.

Other reasons for drooling too much, also called sialorrhea or hypersalivation, may include certain medications, nasal congestion, sleep apnea, neurological conditions, pregnancy, and gastroesophageal reflux disease (GERD).

Sleep Position

The muscles of the body relax during sleep, especially during REM sleep. It's possible that your mouth is falling open as you sleep. If you sleep on your side or your stomach, drool may be more likely to escape from the sides of your mouth as you sleep.

If you drool because of the position you sleep in, changing sleep positions and sleeping on your back may help resolve the problem.

Medication

Drooling can be a side effect of certain medications, including sedatives, antipsychotic drugs, some antibiotics, certain medications used to treat Alzheimer's disease, and some nonsteroidal anti-inflammatory drugs (NSAIDs).

If you are taking a medication that causes drooling as a side effect, don't stop taking it, but reach out to your healthcare provider if you are concerned.

Nasal Congestion

One of the biggest reasons your mouth could open during sleep is that you can’t breathe well through your nose. If you're congested because of a cold or allergies, you may begin to breathe through your mouth. If this occurs in your sleep, you may drool on your pillow.

Treating allergies with medication or taking steps to keep allergens out of your home can help you breathe more easily through your nose and prevent drooling. If you have a cold, try taking a decongestant or using a humidifier.

Deviated Septum

A deviated nasal septum can also be to blame for overnight drooling. Inside your nose, a thin wall called a septum separates the two sides. If you have an off-center or uneven septum, airflow on the narrower side could be partly blocked. This may cause you to snore though your mouth, which can lead to drooling when you sleep.

Managing your deviated septum with medications or surgery called a septoplasty can help reduce uncomfortable symptoms like drooling while sleeping.

Sleep Apnea

Sleep apnea, a condition in which your breathing pauses during sleep, can cause nighttime mouth breathing and excess saliva. In addition to drooling when you sleep, other sleep apnea symptoms may include:

• Loud snoring
• Sounds of choking
• Feeling tired during the day

Sleep apnea is a serious condition. If you believe you may have it, it's important to reach out to your healthcare provider right away. Sleep apnea treatments can include lifestyle changes, medical devices that help with breathing, and possibly surgery.

Infection

If you have excess saliva and pain in your mouth or gums, you may have an infection or cavity in your teeth. Creating more saliva is one way the body might try to fight off an infection in the mouth. See your dentist for a cleaning and thorough check-up.

An infection of the epiglottis—the cartilage that covers your windpipe—can also cause drooling. Epiglottitis begins with a fever and sore throat and can progress to difficulty breathing and swallowing. This condition can be life-threatening; see a healthcare provider right away if you have any condition that causes breathing problems.

Gastroesophageal Reflux Disease

Drooling in your sleep can also be related to gastroesophageal reflux disease (GERD), a condition that causes frequent acid reflux. Aside from heartburn, another symptom of GERD is dysphagia, or difficulty swallowing. This can cause a choking sensation or a feeling as if there's food stuck in your throat, which can lead to excess salivation and drooling.

Neurological Conditions

Some people produce excess saliva, a condition called sialorrhea. Sialorrhea can be a result of:

• Brain injury
• Stroke, which blocks blood supply to the brain
• Parkinson's disease, a progressive condition that impacts movement
• Cerebral palsy, a group of conditions that affect movement and balance
• Huntington's disease, a progressive condition that causes the destruction of neurons in the brain
• Bell's palsy, a nerve condition that causes weakness on one side of the face
• Amyotrophic lateral sclerosis (ALS), a progressive nerve disease
• Vitamin B12 deficiency, which can sometimes cause neurological problems that lead to drooling

These conditions can make it harder to swallow. If you have a hard time swallowing, you may drool while you sleep and during the day as well.

Medications like Botox injections, prescription oral medications, and prescription patches can help manage drooling if you have an underlying neurological condition.

Teeth Grinding

Nocturnal bruxism (teeth grinding at night) can be associated with drooling.

Excessive salivation can also be a side effect of wearing a mandibular device (like a night guard) to manage nocturnal bruxism.

Pregnancy

Salivating more during pregnancy, also known as ptyalism gravidarum, is a common occurrence in early pregnancy and can lead to drooling while you sleep. Other associated symptoms include:

• Swollen salivary glands
• Difficulty sleeping
• Social and emotional distress
  

Summary

Drooling in your sleep isn't uncommon and may not be a sign of a health problem. It can happen because you're breathing through your mouth instead of your nose. Congestion, your nasal anatomy, and sleep apnea can cause you to breathe through your mouth.

Sometimes people produce more saliva than they can swallow. Medications and early pregnancy can cause this kind of overproduction. Some health conditions make it harder to swallow, too, leading to drooling throughout the day.