Why Do I Drool When I Sleep?

QUESTION

I just turned 66 and recently noticed that I’ve started drooling when I sleep. Is something wrong?

ANSWER

Probably not. Many people drool during their slumber. That’s because our muscles relax during sleep, and a slackened jaw can allow the mouth to open—especially during the deep stages of sleep. Breathing through an open mouth then dries out the tongue, so the salivary glands produce even more saliva to keep the mouth moist. The extra saliva often drips out of the mouth and onto the pillow. This is even more likely to occur if you sleep on your stomach or side. If the drooling bothers you, all you may need to do is switch sleep positions so that you’re on your back.

That said, drooling also can be a sign of a medical condition. Obvious causes include allergies or a cold that leads to nasal congestion, or the inflammation of chronic sinusitis could make it hard to breathe through the nose. Another possibility is a deviated (off-center) nasal septum (the bone and cartilage in the nose that separates the nostrils). This condition can block air flow through the nasal passages and cause mouth breathing. An ear, nose and throat specialist (otolaryngologist) can advise you on treatment for a deviated septum, which may include a relatively simple surgical procedure. You may also want to check any medications that you’re taking. Some drugs can cause excessive saliva production, such as clonazepam (Klonopin), a seizure medication that is also used to treat anxiety, or certain antipsychotics.

Drooling also can be a sign of sleep apnea, a disorder in which breathing briefly stops during sleep. Symptoms include snoring, gasping for breath during the night and excessive daytime sleepiness. If you have any of these symptoms, you should be evaluated by a sleep specialist. Treatment may include a continuous positive airway pressure (CPAP) device that delivers air via a mask covering the nose during sleep. Note: Even though sleep apnea is more common in men, it can also occur in women.

If you have a condition that makes it difficult to swallow, such as Parkinson’s disease, you may notice drooling—not only at night but during the day. The FDA recently approved a drug, incobotulinumtoxinA (Xeomin), for such patients who often experience excessive drooling.

For most people, however, drooling isn’t that serious—and can be addressed by treating any underlying condition (such as those described above) or switching your sleep position.