Drooling during sleep (sometimes called sialorrhea or hypersalivation) is when excess saliva escapes from the mouth while you are sleeping. It happens to many people, sometimes occasionally, sometimes more frequently.
Saliva is produced all the time, even during sleep. Normally we swallow saliva or keep it in the mouth or throat, but when muscle control relaxes during sleep (especially deep sleep), or if mouth posture changes (mouth open, head turned, etc.), saliva can escape.
Common, harmless causes of drooling while sleeping
Here are reasons why drooling during sleep is often not a serious problem:
- Sleep position: Sleeping on your side or stomach makes it easier for saliva to pool and leak out. Sleeping on your back can reduce that.
- Mouth breathing: If your nose is blocked (due to allergies, a cold, sinus issues), you may breathe through your mouth, which can cause your lips to part and allow drool to escape.
- Relaxed muscles during deep sleep: In deep or REM sleep stages muscles relax, including those that control swallowing and keeping saliva in.
- Temporary illness, allergies or infection: Nasal congestion or sinus infections can lead to more drooling. Also, general throat or oral irritation.
- Medication side effects: Some medications increase saliva production, relax muscles, or affect the nerves controlling swallowing.
- Acid reflux / GERD: Stomach acid irritating the throat can lead to difficulty swallowing or a feeling of lump in throat, which may produce extra saliva.
- Temporary factors like fatigue, dehydration, or pregnancy: These can all influence saliva flow or how well muscles keep things sealed.
When drooling may be a sign of something more serious
While often harmless, frequent or very heavy drooling during sleep could hint at more serious underlying issues. Things to watch for:
- If drooling is sudden or much more than usual.
- If it’s accompanied by other symptoms like sore throat, difficulty swallowing, breathing problems, choking, coughing, snoring loudly, gasping for air during sleep, daytime sleepiness, or headaches.
- If you have neurological conditions (stroke, Parkinson’s disease, ALS, etc.) that can affect the nerves or muscles involved in swallowing.
- If it’s interfering with sleep quality or causing discomfort (skin irritation, infections, etc.).
- If medications you’re taking list drooling as a side effect and you started them recently.
Possible complications if drooling is frequent/severe
- Bad breath
- Skin irritation around the mouth
- Wet bedding, discomfort, disrupted sleep
- Risk of aspiration (inhaling saliva), especially in people whose swallowing reflexes are impaired
- Psychological stress, embarrassment
What you can do to reduce or stop drooling
Here are strategies that often help:
Change sleep position: Try sleeping on your back rather than your side or stomach. Use pillows to support and maintain position.
Keep nasal passages clear: Use decongestants, nasal strips, saline sprays, treat allergies or sinus infections.
Elevate the head: A wedge pillow or raising the head of the bed can help.
Oral hygiene and dental checkups: Infections in mouth or gums increase saliva; addressing dental issues helps.
Modify medications (if applicable): Talk to a doctor about whether your medication could be causing drooling, or if there are alternatives.
Speech therapy or exercises: Strengthening tongue, lip, jaw muscles; improving swallowing function.
Use oral appliances: Devices that help with keeping lips closed, tongue in position; sometimes used in sleep-disordered breathing contexts.
If GERD / Acid reflux: Lifestyle changes (diet, smaller meals, avoid eating close to bedtime), medications if needed.
Botox: In some cases, botulinum toxin injections are used in the salivary glands to temporarily reduce saliva production in individuals with neurological disorders.
Surgery: In severe or persistent cases, procedures to reroute or remove salivary glands may be discussed—usually as a last resort.
When to see a doctor
You should consider seeing a healthcare provider if:
- The drooling is very heavy, persistent, or gets worse
- It is newly onset without clear cause (no allergies or cold etc.)
- It’s accompanied by other symptoms like choking, breathing issues, swallowing difficulties, changes in facial drooping or muscle control
- You suspect a neurological issue
- It interferes with quality of sleep, causing daytime fatigue, etc.
A doctor may do an evaluation that looks at your sleep, possibly sleep apnea testing, neurological exam, medication review, dental/ENT (ear-nose-throat) evaluation.
How is chronic drooling diagnosed?
Diagnosis usually starts with a detailed health history and physical exam. Your provider will assess:
- The frequency and severity of drooling
- Your sleep habits and posture
- Whether nasal congestion or mouth breathing plays a role
- Whether there’s any involvement of neurological or swallowing problems
- Any medications or substances that might affect saliva production
In some cases, sleep studies or imaging (like MRI for neurological concerns) may be required to understand the cause better.
Drooling and sleep disorders
If you snore, wake up tired, or experience choking/gasping during sleep, you may have a sleep disorder like sleep apnea. Sleep apnea is one of the most underdiagnosed yet serious causes of nighttime drooling. Obstructive sleep apnea causes temporary pauses in breathing during sleep. This can lead to mouth breathing, poor oxygen levels, fragmented sleep, and in some cases, drooling.
Sleep apnea symptoms can include:
- Loud snoring
- Gasping or choking during sleep
- Dry mouth or sore throat upon waking
- Daytime fatigue or poor concentration
- Morning headaches
If drooling is combined with these, it’s a good idea to seek out a sleep specialist. A home sleep study or overnight sleep lab test (polysomnography) may be recommended.
Drooling and neurological disorders
People with neurological conditions are more likely to experience chronic drooling due to muscle control problems, impaired swallowing reflexes, or increased saliva production. This includes:
- Parkinson’s disease
- Stroke recovery
- Cerebral palsy
- Multiple sclerosis
- Amyotrophic lateral sclerosis (ALS)
For these patients, treatment is usually more involved. A combination of medications (anticholinergics to reduce saliva), speech therapy, botulinum injections, or in some cases, surgery, may be used to manage symptoms.
Drooling in children
It’s normal for babies and toddlers to drool, especially during teething or if they use pacifiers. But if drooling continues beyond age 4 or becomes excessive, especially during sleep, it may be worth assessing:
- Mouth breathing
- Enlarged tonsils or adenoids
- Allergies
- Speech or swallowing disorders
- Neurological conditions like cerebral palsy
In many cases, pediatric ENT or speech-language pathologist evaluations can offer simple therapies or treatments.
Home remedies to try for mild sleep drooling
- Sleep on your back and train your body with supportive pillows
- Keep bedroom airways humidified (dry air worsens mouth breathing)
- Stay hydrated throughout the day
- Avoid spicy or acidic foods at night
- Limit alcohol or sedative use close to bedtime
- Practice deep breathing through your nose to train nasal breathing
- Try essential oils (eucalyptus, peppermint) in a diffuser to reduce nasal inflammation
Myths about drooling in sleep
Myth 1: Only children drool in their sleep
Truth: Adults drool too, especially during deep sleep, if sick, or due to other factors. It’s very common.
Myth 2: Drooling is always a sign of a serious problem
Truth: Most of the time, it’s harmless and related to temporary factors like nasal congestion or sleep posture.
Myth 3: You can’t stop it
Truth: There are many ways to manage or eliminate excessive nighttime drooling once the root cause is known.
Conclusion
Drooling during sleep is something most people will experience at some point. For many, it’s no more than a side effect of how you’re sleeping or a temporary health issue. However, if it’s frequent, excessive, or connected to other symptoms—such as poor sleep, breathing trouble, or signs of neurological problems—it’s worth investigating further. By paying attention to sleep posture, treating nasal issues, checking medications, and ruling out serious conditions like sleep apnea or GERD, you can often manage or eliminate the issue entirely.
Need help figuring out if your drooling might be serious? You can start by tracking your sleep, your diet, and any medications. Then bring that to your doctor or a sleep specialist. With the right attention, you’ll not only stop the drool—but also improve your sleep quality and overall health.