Ashwin Lewis
Drooling, or spitting, in your sleep is a common occurrence. It is caused by relaxed swallowing reflexes, but can also be a symptom of a health condition. While sleeping, people swallow less frequently, which can cause saliva to accumulate and escape from the mouth. The sleep position can also affect drooling, with side and stomach sleepers more prone to drooling due to the effects of gravity. In some cases, drooling may indicate an underlying medical or neurological condition, such as sleep apnea, allergies, infections, acid reflux, or more serious disorders. If you experience excessive drooling or other concerning symptoms, it is recommended to consult a healthcare professional for personalized advice and treatment options.
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Sleeping positions
Drooling or spitting in your sleep is normal. However, your sleeping position can affect how much you drool. When you sleep on your back, gravity usually keeps saliva in your mouth or throat. On the other hand, if you sleep on your side or stomach, gravity is more likely to pull saliva down towards your pillow, resulting in drooling.
Back sleeping
Sleeping on your back is a natural position for many people. However, it can contribute to snoring, sleep apnea, and acid reflux. When you lie on your back, gravity can pull your tongue and soft tissues around your throat into a position that blocks your breathing, leading to disrupted breathing or positional obstructive sleep apnea (OSA). Back sleeping can also worsen neck pain. On the positive side, it can help alleviate low-back pain.
Side sleeping
Side sleeping is the most common sleep position, especially among women. This position can help relieve back pain and reduce sleep apnea symptoms. It is also beneficial for people with acid reflux or heartburn, as sleeping on the left side can alleviate symptoms. Side sleeping is generally considered to be better for spinal support and balance, which relieves pressure and enables muscles to relax and recover.
Stomach sleeping
Stomach sleeping is the least common position. It may help prevent snoring but can strain your neck and lower back. Sleeping on your stomach can also cause restlessness, making it difficult to get comfortable.
While the above sleeping positions are the most common, there are variations within each category. For example, side sleepers may sleep with their arms down, in front of their bodies, or wrapped around a pillow. These variations may be influenced by comfort, mattress type, and personal preference.
Ultimately, the best sleeping position is one that promotes healthy spinal alignment and provides comfort. It is important to experiment with different positions and pillows to find what works best for your individual needs and preferences.
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Underlying health conditions
Drooling, or spitting, during sleep is usually normal. However, in some cases, it can be a symptom of an underlying health condition. If you suspect this to be the case, it is important to seek treatment.
Obstructive Sleep Apnea (OSA)
OSA is a sleep-related breathing disorder that causes temporary pauses in breathing during sleep. Mouth breathing often accompanies or worsens OSA, and drooling is commonly associated with it. If you experience other symptoms of OSA, such as snoring or gasping for air during sleep, consult a healthcare professional.
Neurological Conditions
Drooling can be a symptom of neurological conditions such as cerebral palsy, Parkinson's disease, multiple sclerosis (MS), and muscular dystrophy. These conditions can affect muscle control, making it difficult to swallow and leading to excess saliva production.
Gastrointestinal Issues
Gastrointestinal reflux disorder (GERD) is a condition where stomach contents flow back into the oesophagus, causing a feeling of a lump in the throat and leading to excessive drooling in some people. Other gastrointestinal issues, such as infections or acid reflux, can also contribute to drooling during sleep.
Allergies and Medications
Allergies and certain medications can also increase the likelihood of drooling during sleep. Antipsychotic drugs, Alzheimer's medications, and some antibiotics have been linked to excessive drooling. If you suspect that your medication is causing drooling, consult your healthcare provider.
Other Conditions
In some cases, drooling can be a sign of other health conditions. For example, drooling can occur after a stroke or be associated with cancer. If you are concerned about excessive drooling, it is important to seek medical advice.
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Sleep apnea
Spitting in your sleep, also known as nocturnal sialorrhea, is characterised by the excessive production and expulsion of saliva during sleep. While drooling in your sleep is common, persistent and excessive spitting may indicate an underlying health issue.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that causes temporary pauses in breathing while you sleep. Mouth breathing often accompanies or worsens OSA, and can make drooling more likely as saliva can more easily escape when the mouth is open. OSA is a potential underlying cause of sleep-related spitting and drooling.
Other potential causes of sleep-related spitting include gastroesophageal reflux disease (GERD), certain neurological disorders, diabetes, and other health conditions. Medications and their side effects can also be a factor, with certain antipsychotics, anticonvulsants, and over-the-counter medications increasing saliva production or affecting the body's ability to manage it during sleep. Stress and anxiety can also contribute to sleep-related spitting, as heightened emotional states can lead to increased muscle tension in the jaw and face, potentially affecting saliva control during sleep.
If you are concerned about sleep-related spitting, it is important to consult a healthcare professional, who can assess whether it is a symptom of an underlying health condition and provide personalised advice or treatment options.
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GERD
Drooling in your sleep is normal and is caused by relaxed swallowing reflexes. However, excessive drooling may be a symptom of a health condition. For example, drooling commonly accompanies sleep bruxism and sleep apnea, a sleep-related breathing disorder that causes temporary pauses in breathing while you sleep. Mouth breathing often accompanies or worsens sleep apnea, making drooling more likely as saliva can more easily escape when the mouth is open.
If you sleep on your back, gravity usually keeps saliva in your mouth. On the other hand, if you sleep on your side or stomach, you are much more likely to drool. This is because gravity pulls the saliva down toward the pillow, and if you sleep with your mouth open, saliva can escape more easily.
Excessive drooling is called sialorrhea or hypersalivation and can be caused by various factors, including difficulty swallowing, issues with muscle control, or too much saliva production. Certain medications can also cause excessive drooling, such as antipsychotic drugs, antibiotics, and medications used to treat Alzheimer's.
Gastrointestinal reflux disorder (GERD) is a digestive condition in which stomach contents flow back into the oesophagus, damaging its lining. GERD can cause dysphagia (difficulty swallowing) or a feeling of a lump in the throat, leading to excessive drooling in some people.
If you are concerned about excessive drooling, consult a healthcare professional. They can assess whether your drooling could be a sign of an underlying health condition and provide personalized advice or treatment options.
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Allergies
While spitting or drooling in your sleep is common, it can sometimes be caused by allergies.
If you wake up to a wet patch on your pillow, it's likely that excess saliva escaped your mouth while you slept. While drooling is normal, it can sometimes be a sign of an allergy or other medical condition. Allergies can cause increased saliva production and a stuffy nose, leading to mouth breathing and drooling. Seasonal allergies, for example, can inflame your sinuses and block your airways, making it harder to breathe through your nose.
If you suspect allergies are causing you to drool at night, consult a healthcare professional. Allergy treatment could open up your sinuses, enabling you to breathe through your nose, reducing drooling. Treatments for drooling include medications such as scopolamine, glycopyrrolate, and atropine sulfate, which reduce excess saliva. Botulinum toxin injections, such as Botox, can also be used to safely and effectively prevent overproduction of saliva.
Other causes of drooling include sleep position, certain foods and beverages, and medical conditions such as infections, acid reflux, or neurological disorders. If you are a side or stomach sleeper, gravity is more likely to pull saliva down toward the pillow, resulting in drooling. Changing your sleep position to sleeping on your back may help, as gravity will keep saliva in your mouth.
If you are concerned about drooling in your sleep, speak to a healthcare professional, who can advise on personalised treatment options.
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Frequently asked questions
Yes, drooling in your sleep is normal. Saliva production continues during sleep, and people who sleep on their side or stomach are more likely to drool.
Sleeping on your back may help to minimise drooling. Other treatments include medications, Botox injections, and motor therapy.
Yes, drooling can be a symptom of a health condition. If you are concerned about the amount you are drooling, consult a healthcare professional.
Drooling can be associated with various medical and neurological conditions, including sleep apnea, cerebral palsy, Parkinson's disease, and acid reflux.
