Salivating While Asleep: Why Don't We Drool In Dreamland?

Drooling in your sleep is often perfectly normal. However, excessive drooling may signal an underlying health condition. Drooling occurs when saliva escapes your mouth, usually due to relaxed swallowing reflexes. This can be caused by sleeping on your side or stomach, which makes it easier for saliva to escape from the sides of your mouth. In addition, certain medications, nasal congestion, sleep apnea, neurological conditions, pregnancy, and gastroesophageal reflux disease (GERD) can also cause drooling.

The position you sleep in

Side and stomach sleepers who sleep with their mouths open are even more likely to drool. This is because the accumulated drool can slip out from the lips when they part to breathe. Therefore, sleeping on your back can help to minimise drooling.

If you are a side or stomach sleeper, you can try switching to sleeping on your back. You may need to get a new pillow to sleep comfortably in this position. Side sleepers usually require a thicker pillow, while stomach sleepers often use a thinner pillow or none at all. If you find it difficult to stay on your back throughout the night, place additional pillows along the sides of your body to help you stay in position.

Sinus infections and allergies

Allergies can also cause similar symptoms, such as a stuffy or runny nose, and a dry or swollen throat, which can make breathing difficult while asleep. Allergies are often worse at night due to several reasons. Firstly, our bedrooms tend to have a high concentration of dust mites, and lying down can worsen nasal congestion due to increased blood flow to the head. Additionally, any pollen that may be on your skin or hair can transfer to your bedding. These allergens can irritate the nasal passages, making it challenging to breathe and sleep comfortably.

To alleviate sinus issues and allergies before bedtime, here are some recommendations:

• Avoid drinking alcohol and caffeine before bed, as they can contribute to dehydration, which is a trigger for sinus problems.
• Consult your healthcare provider about taking antihistamines or over-the-counter allergy medications to control allergy symptoms.
• Maintain a clean and dust-free bedroom, free of pet dander and pollen. Wash your bedding and pillowcases regularly.
• Use a humidifier to soothe dry sinus passages and maintain moisture in the air.
• Try saline nasal sprays, inhaling steam, or over-the-counter decongestants to reduce nasal congestion.
• For severe or persistent sinus issues, consider consulting an ear, nose, and throat (ENT) specialist for further evaluation and treatment options, such as balloon sinuplasty or endoscopic sinus surgery.

Sleep apnea

While drooling during sleep is normal, it can sometimes be linked to sleep apnea. 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 mouth breathing during sleep may make drooling more likely as saliva can more easily escape when the mouth is open.

If you are experiencing OSA, you may also notice the following symptoms:

• Snoring, gasping, or choking while asleep
• Waking up during the night
• Difficulty focusing during the day
• Drowsiness during waking hours
• A sore throat or dry mouth upon waking

If you are experiencing one or more of these symptoms in addition to drooling, it is recommended that you consult a doctor.

The most recommended treatment for OSA is the use of a continuous positive airway pressure (CPAP) machine, which blows air with continuous pressure down your throat at night to keep your airways open while you sleep. CPAP machines are small, lightweight, and fairly quiet, and they can improve sleep quality, relieve daytime sleepiness, and lower blood pressure.

Other treatments for OSA include:

• Mandibular advancement devices (MADs): These devices look like mouth guards and are fitted by a dentist or orthodontist. They snap over the upper and lower dental arches and have metal hinges that make it possible for the lower jaw to be eased forward.
• Tongue-retaining devices: These are less common but are used to hold the tongue in place to keep the airway open.

Neurological conditions

While drooling during sleep is common, it can sometimes be a symptom of a more serious health condition. Neurological conditions that can cause drooling include:

• Parkinson's disease, a progressive movement disorder
• 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
• Amyotrophic lateral sclerosis (ALS), a progressive nerve disease
• Multiple sclerosis (MS)
• Vitamin B12 deficiency, which can sometimes cause neurological problems that lead to drooling
• Traumatic brain injuries
• Stroke
• Bell's palsy, a nerve condition that causes weakness on one side of the face

If you are concerned about drooling in your sleep, it is important to consult a healthcare professional. They can help determine if your drooling is caused by a health condition and provide personalized advice and treatment options.

Pregnancy

Excessive salivation during pregnancy, or ptyalism gravidarum, is a common occurrence and can lead to drooling while you sleep. It is often accompanied by swollen salivary glands, which can affect your sleep. Ptyalism is relatively rare and is most often reported by women who also experience morning sickness. It is not harmful to the mother or the baby and is considered a normal part of pregnancy.

Ptyalism is common during the first trimester of pregnancy, but it can also occur in the second and third trimesters as the uterus continues to grow. It usually resolves by the start of the second trimester, but there are rare cases where it continues until delivery and may even increase as the pregnancy progresses.

The exact cause of ptyalism is unknown, but it is likely due to hormonal changes, acid reflux, morning sickness, dehydration, or a combination of these factors. Pregnancy hormones are known to impact saliva production, especially during the first trimester. Acid reflux, a common condition during pregnancy, can cause a reflex increase in saliva production. Morning sickness can also trigger a response in the body to create more saliva. Dehydration can cause saliva to thicken, giving the sensation of having excess saliva.

There is no medical treatment for ptyalism, but the following measures may help ease the symptoms:

• Eating smaller, more frequent meals
• Brushing teeth and using mouthwash several times a day
• Chewing sugar-free gum or sucking on hard candy
• Taking frequent, small sips of water
• Sucking on lemon wedges or eating sour candy

While ptyalism can be uncomfortable and upsetting, it is a temporary condition that is not harmful to the mother or the baby.

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