Drooling while you sleep might seem like a minor annoyance or even something you laugh about when it happens. However, if you find yourself frequently waking up with a wet pillow, it’s worth paying closer attention. Regular drooling during sleep can sometimes be an early warning sign of underlying health conditions that shouldn’t be ignored. While it’s common for children to drool at night, especially because their muscles are not fully developed to control saliva flow, for adults, it can indicate a potential problem that needs addressing. Take the case of Xiao Liang, a 25-year-old programmer from China.
His story highlights how something seemingly harmless like drooling can lead to a serious discovery. Because of his demanding job, Xiao Liang often worked long hours and stayed up late gaming, leaving him exhausted every day. He found himself catching naps whenever he could, often during his lunch breaks. Over time, he became embarrassed about how often he drooled while sleeping, especially since it always seemed to happen on the same side. Frustrated, he decided to consult a doctor. After hearing his symptoms, the doctor recommended a brain CT scan. The scan revealed that Xiao Liang had an early blockage in his cerebral blood vessels. Fortunately, the issue was caught in time, helping him avoid life-threatening complications like cerebral infarction or hemorrhage.
So, what exactly causes drooling during sleep? Saliva production in the body is managed by the autonomic nervous system, meaning it’s not something you consciously control—similar to your heartbeat. Saliva is produced by the salivary glands, which are divided into major and minor types. There are three pairs of major salivary glands: the sublingual glands, the parotid glands, and the submandibular glands. These glands, along with many minor ones spread throughout the mouth, work around the clock to keep your mouth moist, aid in digestion, fight bacteria, and help keep your teeth clean. On average, a healthy adult produces between one to one and a half liters of saliva per day, with output increasing during meals or when certain nerves are stimulated. However, several factors, like mouth breathing, stress, fatigue, and poor sleep posture, can cause you to drool excessively at night.
When drooling during sleep becomes frequent and noticeable in adults, it can sometimes signal one of several health conditions. For example, oral diseases like pharyngitis, gingivitis, or other maxillofacial inflammations can stimulate excessive saliva production, resulting in drooling. Dental issues such as crooked or loose teeth or uncomfortable dentures may also contribute. Once these dental problems are addressed—such as through orthodontic treatment—drooling often improves. Another potential cause is facial paralysis. When the muscles on one side of the face are paralyzed, the strength and coordination between the two sides become unbalanced. This can make it difficult to control saliva, causing it to leak out more easily, even when you’re awake. If you also notice symptoms like a crooked mouth or difficulty closing one eye, you should seek medical attention immediately.
Gastroesophageal reflux disease (GERD) is another common condition linked to drooling. People with GERD often experience excessive salivation due to abnormal gastric acid that stimulates the salivary glands. Symptoms like acid reflux, heartburn, and chest pain frequently accompany drooling in these cases. Parkinson’s disease is also known to cause nighttime drooling. As the disease progresses, people with Parkinson’s often experience difficulty swallowing, leading to saliva pooling in the mouth. Nerve damage associated with the disease may also increase saliva production. Cerebral thrombosis, or a blood clot in the brain, can disrupt the muscles that control swallowing and mouth function, resulting in drooling. This is especially concerning if other symptoms like asymmetrical facial muscles, saliva pooling on one side, or difficulty closing one eye are present. Arteriosclerosis, or the hardening of arteries, is another condition that can contribute to nighttime drooling. Reduced blood flow to the brain can weaken facial muscles and impair swallowing, making it easier for saliva to escape the mouth during sleep. Middle-aged and older adults with high blood pressure, high cholesterol, or diabetes should be especially mindful of these signs.
If you’re dealing with persistent drooling during sleep, there are a few strategies that can help minimize or stop it altogether. First, adjusting your sleeping position can make a big difference. Sleeping on your back can reduce drooling by keeping your mouth closed and aligning your body properly. Using a U-shaped neck pillow can also help maintain a more stable head position, reducing the risk of saliva escaping. Second, maintaining good oral hygiene is essential. Brush your teeth twice a day, use fluoride toothpaste, floss daily, and rinse your mouth after meals. Good dental care helps prevent gum disease and tooth decay, both of which can increase saliva production. Lastly, if you think your medication may be causing you to drool excessively, speak with your doctor about alternative options. Never adjust or stop taking medication without professional guidance. While drooling during sleep might seem like a minor issue, it can sometimes reveal important information about your overall health. Paying attention and addressing the root cause can make a significant difference.
