Drooling, also known as sialorrhea in medical terminology, describes the unintentional hypersecretion (discharge of excessive) saliva and other oral substances from the mouth during sleep. Drooling in sleep can be caused when there is difficulty in swallowing the saliva produced. In some cases, experts say that it can be due to existing neurological conditions like facial palsy, Parkinson’s, post-stroke, or weak neuromuscular development. A specialist can diagnose the severity and underlying conditions and In severe cases, drooling can be dealt with using medications and surgical interventions.
Drooling is common at an early age (under two years of age). This might be because some parts of the facial muscles have not developed, or they have not gained control of facial muscles, says, Dr Hirennappa B Udnur, Consultant Pulmonologist, Manipal Hospital, Bangalore. Drooling can lead to interrupted sleep as it leads to sudden waking up to dampness in or around the pillow, he added.
However, he cautions that drooling can be prominent in children with central nervous system and muscular disorders which requires medical attention or even surgery.
Drooling affects quality of sleep
During the night, the tone (the tension in muscle caused due to activities) of our facial muscles varies between different sleep phases. The tension in our muscles decreases at night. Due to this muscle relaxation during sleep, there is no conscious effort in managing saliva and controlling the mouth muscle. This amplifies drooling in sleep, adds Dr Udnur.
What causes drooling in sleep?
Increased salivary production and position of sleep:Â Sleeping with mouth open can lead to drying because of which there can be enhanced production of saliva during sleep. Sleeping in lateral position (turning to a side) can also can more drooling, says Dr Suman Mantri, Senior Consultant, Pulmonology and Sleep Medicine, Apollo hospitals, Bengaluru.
Neurological conditions: Neurodegenerative conditions such as Parkinson’s disease, advanced dementia and stroke can also cause drooling, says Dr Sinjan Ghosh, consultant Neurology, Fortis Hospital, Kolkata. People with Bell’s palsy (paralysis or weakness of facial muscle) can have drooling from the weaker side of the face.
Another important medical condition is motor neuron disease (rare condition affecting brain and nerves) which affects the muscles of swallowing, muscles of speech and the process of swallowing. This can also produce drooling due to difficulty in swallowing the saliva.
Allergies and Respiratory Issues: Allergic rhinitis (sneezing, nasal congestion, itchiness in nose and watering of eyes) can also cause excessive fluid in the mouth, leading to drooling.
Sleep disorders: Obstructive Sleep Apnea (OSA) characterized by interrupted breathing during sleep, can lead to drooling, highlights Dr Ghosh.
Oral Health Concerns: Pre-existing dental problems, such as caries (damaged teeth), malocclusion (misaligned teeth when jaw is closed) or difficulty swallowing due to oral infections, may increase drooling.
Certain Medications: Dr Ghosh emphasizes that certain medications can cause excessive saliva production in individuals with Alzheimer’s condition (the most common type of dementia), which can contribute to drooling.
Other medical conditions:  Gastroesophageal Reflux Disease (GERD) can cause acid reflux, leading to increased saliva production and drooling during sleep.
Age factor: In elderly, weakness in facial muscles can result in inability to manage saliva, which may lead to drooling, says Ghosh.
Takeaways
- While occasional drooling is usually normal, persistent or excessive drooling can result from underlying serious neurological conditions.
- Sleep disorders, neuro-muscular and neuro degenerative conditions, allergies and other issues can increase drooling during sleep time.
- Management of drooling includes making changes in sleep position, taking care of oral health, exercises to strengthen facial muscles or in critical cases surgeries and botox injections can be effective.
