Prevent Drooling While Asleep: Tips For A Dry Slumber

Drooling in your sleep is often normal and can be caused by several factors, such as the position you sleep in, excess saliva production, or breathing through your mouth. While it is usually not a cause for concern, it can be unpleasant and embarrassing for many people and may indicate an underlying health condition.

Change your sleep position

Changing your sleep position is one of the easiest ways to prevent drooling. If you sleep on your side or stomach, gravity will cause saliva to escape from your mouth. Therefore, sleeping on your back can help to minimise drooling.

If you sleep on your side or stomach, you may need to get a new pillow to sleep comfortably on your back. Side sleepers usually use a thicker pillow, while back sleepers use a thinner one. If you're having trouble staying on your back, place additional pillows along the sides of your body to help you stay in position.

You can also take measures to breathe through your nose while you sleep, such as using mouth tape. This can help to keep your mouth closed and prevent drooling.

Treat allergies and sinus problems

Allergies and sinus problems are a common cause of drooling while you sleep. If you are drooling because of allergies, treating the allergies may help to reduce drooling.

Allergic sinusitis is a reaction to exposure to inhalants such as dust, pollen, smoke, and animal dander. Symptoms include nasal congestion, post-nasal drip, itchy eyes, nose and throat, headaches, pain, tenderness, swelling, and pressure around the forehead, cheeks, nose, and between the eyes. It can also cause behavioural changes, sleep problems, and a reduced sense of smell and taste.

If you are experiencing these symptoms, you should see a doctor. They may be able to diagnose you with a detailed medical history and physical examination, allergy skin tests, a nasal endoscopy, or a computed tomography (CT) scan.

There are a number of treatments for allergic sinusitis. For mild seasonal allergies and allergies to pet dander, avoidance is the most effective course of action. However, this is not always possible, as not all allergens can be avoided.

Some self-help and pharmaceutical remedies include:

• Saline nasal sprays to rinse your nasal passages
• Inhaling steam to reduce nasal congestion
• Over-the-counter decongestants to reduce congestion
• Corticosteroid nasal sprays to reduce inflammation
• Allergy shots to desensitize you to the allergen
• Over-the-counter pain relievers (but do not give acetylsalicylic acid, i.e. aspirin, to children)

If these treatments are insufficient, or if the allergic sinusitis is severely impacting your quality of life, you may need to consider more intensive treatments. Balloon sinuplasty is a less invasive procedure than traditional surgery, which uses small balloons to expand the openings of the sinuses. Endoscopic sinus surgery may also be an option, where a flexible tube is inserted into the nasal passages to remove the problem tissue or polyps causing the nasal blockage.

Use a mandibular device

Mandibular devices are a type of oral appliance worn during sleep to help reduce drooling, snoring, and teeth grinding. They work by keeping the lips closed and ensuring the tongue and teeth are in the correct position. This prevents the jaw from falling open and allows drool to escape.

Mandibular devices are a good option for those who suffer from mild to moderate sleep apnea and sleep on their side, as they increase airway space and reduce throat constriction. They are also useful for people who have receding jaw structures. However, they are not suitable for people with severe sleep apnea, central sleep apnea (a neurological condition), or those who wear dentures or have severe dental issues.

There are two main types of mandibular devices: custom or semi-custom devices that are made to fit a specific person's mouth, and boil-and-bite devices that are available over the counter. Boil-and-bite devices are made from soft materials that become pliable when exposed to hot water, allowing the user to create a mould of their teeth by biting into the material as it cools.

While mandibular devices are generally well-tolerated, some people may experience side effects such as discomfort in the jaw and mouth area. In addition, mandibular devices may not be effective for everyone, and continuous positive airway pressure (CPAP) therapy remains the gold standard treatment for sleep apnea. However, CPAP therapy also has lower adherence rates, with about 50% of people eventually abandoning treatment.

If you are considering using a mandibular device to reduce drooling during sleep, it is important to consult with a healthcare professional or a qualified dentist who has training in this area. They can help determine if this treatment option is suitable for you and provide guidance on the different types of devices available.

Take medication

If you are taking medication and are concerned that it is causing you to drool in your sleep, it is important to first consult your doctor. Drooling is a known side effect of certain medications, including:

• Antipsychotics, such as Clozaril (clozapine)
• Antibiotics
• Alzheimer's medications
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Sedatives
• UTI medication Urecholine (bethanechol)
• Glaucoma and dry mouth medication Salagen (pilocarpine)
• Sjogren's syndrome medication Evoxac (cevimeline)
• Alzheimer's and dementia medications Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine)
• Benzodiazepines, such as Xanax (alprazolam), Librium (chlordiazepoxide), and Valium (diazepam)

If you are taking any of these medications and are concerned about drooling, do not stop taking your medication. Instead, speak with your doctor about your concerns and ask if they can recommend an alternative medication.

In some cases, a doctor may recommend medication to treat drooling, especially if it is caused by a neurological condition. For example, a doctor may prescribe scopolamine, also known as hyoscine, which is often delivered in the form of a patch placed behind the ear. This medication intercepts nerve impulses before they reach the salivary glands, reducing saliva production. Another option is glycopyrrolate, which also decreases saliva production by blocking nerve impulses but may have more severe side effects.

Try speech therapy

Speech therapy can be an effective treatment for adults who experience excessive drooling. It can help to improve jaw stability, tongue strength, and mobility of the lips. The best course of treatment will depend on the specific cause of the drooling.

A speech therapist will first conduct an evaluation to determine the baseline of the muscle function in the lips, cheeks, jaw, tongue, and soft palate. They will assess various muscle functions, such as the response to pressure and movement, as well as the strength of movement. Once the cause of the drooling is determined, a speech therapist may recommend one of the following therapeutic strategies:

Oral Facial Facilitation

Oral facial facilitation is a speech therapy method used to improve oral motor control, sensory awareness, and the frequency of swallowing. This technique includes a variety of exercises aimed at improving muscle tone and saliva control. Examples include applying ice, brushing teeth before meals, using vibrations, and manipulating muscles through tapping, stroking, or patting with fingertips to improve oral awareness.

Developing Eating and Drinking Skills

Drooling can be exacerbated by poor eating and drinking habits. A speech therapist can help develop better techniques surrounding lip closure, tongue movement, and swallowing. They may also advise against consuming certain foods and drinks, such as alcohol and acidic fruits, which are known to increase saliva production.

Positioning Improvements

Changing body positioning can significantly reduce instances of drooling. A speech therapist will work with individuals to practice good posture and proper trunk and head control, as these skills provide the foundation for improving oral control and reducing drooling. They may also recommend specific sleeping positions, such as sleeping on the back, to minimize drooling at night.

Behavioral Modification

Behavioral modification therapy uses cueing, overcorrection, and positive and negative reinforcement to address drooling in adults. It encourages behaviors such as swallowing and mouth wiping, while discouraging mouth breathing and thumb sucking. This type of therapy can lead to increased awareness of oral functions, increased frequency of swallowing, and improved swallowing skills. It can be easily practiced at home and carries no negative side effects.

Speech therapy offers a range of benefits for adults struggling with excessive drooling, including improved jaw stability and closure, enhanced tongue mobility and strength, better lip closure, and decreased nasal regurgitation during swallowing.

Frequently asked questions