Why Am I Drooling? 4 Causes of Excessive Drooling

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Picture a juicy cheeseburger. A slice of cool, crisp watermelon. Pretty much anything with bacon. Are you drooling yet?

It’s common to jokingly describe a delectable dish as drool-worthy. 

But unwanted, excessive drooling — usually while sleeping — is no laughing matter. It can be annoying and embarrassing. “Excess saliva, also known as hypersalivation or sialorrhea, can be a result of excess production or decreased clearance of saliva,” said Dr. Paula Barry, physician at Penn Family and Internal Medicine Longwood. This can lead to drooling which typically is not cause for concern, but at times can be a sign of a larger health problem.  

If you’re waking up each morning with a drool spot on your pillow, it may be time to find out what’s going on. Here are four causes that could be behind your excessive drooling.

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1. Allergies and Infections

If your body is allergic to something or has an infection, it might produce more saliva to flush the toxins out. In turn, this can make you drool. There are a few different conditions that can cause this reaction:

Seasonal Allergies: Are itchy eyes, a runny nose, and sneezing accompanying your drooling? You might be suffering from seasonal allergies, which can also cause excessive saliva production and lead to drooling . The most common allergens are mold, and pollen — from trees, grass, and weeds.

Sinus Congestion or Respiratory infections: Your sinuses — the hollow air spaces within the bones that surround your nose — can become inflamed because of  the common cold, allergies, or other nasal problems. If your sinuses become inflamed or infected, it can cause a blockage and lead to unwanted drainage. This drainage can eventually come out in the form of drooling.

Strep throat (pharyngitis) and tonsillitis: If you’re having trouble swallowing because your throat hurts, you may have pharyngitis, more commonly known as a sore throat. Pharyngitis can be either viral or bacterial and may present with red and white patches in your throat, swollen glands, and a fever. In addition, your tonsils could be enlarged or inflamed. strep throat. Less swallowing leads to more saliva in the mouth, which can come out during your sleep as drool. "However, you can’t tell you have strep throat by its symptoms alone, so it’s important to speak with your physician for proper diagnosis,” said Dr. Barry. 

So, What About Treatment?

If you think allergies or an infection may be behind your excessive drooling, start with a visit to your primary care provider. In the majority of cases, medication can treat the underlying cause of drooling. If the condition is persistent, you may need to see a physician who specializes in treating ear, nose, and throat (ENT) conditions.

2. Sleep Apnea

Because drool is your saliva escaping your mouth unintentionally, it's more likely to happen when you’re not consciously able to control it, like when you’re sleeping. Sleeping on your side or stomach can create an easy escape route from your mouth. Sleeping on your back may help curb drooling. Then, you don’t have to worry about the unwanted drool spot and mouth crust in the morning.

A sleep disorder called sleep apnea can also be associated with drooling because your airway is either narrowed or blocked. Sleep apnea can take two forms: Obstructive sleep apnea is when your airway is repeatedly blocked during sleep, central sleep apnea is when the brain isn’t sending the right signals that you need to breathe. This irregular breathing can lead to excess saliva production and drool.

What Does Treatment Involve?

If you aren’t sure whether sleep apnea is the culprit, start with a visit to your primary care provider. They can determine if you simply need to adjust your sleeping position, or if you will need further evaluation from an Ear, Nose and Throat (ENT) or sleep medicine specialist. They may recommend a sleep study to determine if you have sleep apnea. If so, the condition is often managed successfully with continuous positive airway pressure (CPAP).   

3. Side Effect of Medications

Sometimes, certain medications can increase the amount of saliva your body produces, especially if you take medications for:

  • Psychiatric disorders
  • Alzheimer’s disease
  • Myasthenia gravis (a neuromuscular disease that causes weakness in the skeletal muscles)

What Does Treatment Involve?

The type of provider you see depends on the specific medication and why the medication was prescribed. For example, if it was prescribed for depression, you may see a behavioral health specialist who can discuss other possible treatment options. If it was prescribed for Alzheimer’s disease, a neurologist may be the best fit.

If you’re not quite sure, start with your primary care provider or pharmacist.

4. Difficulty Swallowing Caused by Stroke or Neurological Disorders

Some conditions — including certain neurologic disorders or stroke — can lead to what’s called dysphagia. This is when you have pain or difficulty swallowing, and some people cannot swallow at all. As if that’s not bothersome enough, drooling can come next. 

Nervous System Disorders: Disorders like amyotrophic lateral sclerosis (ALS), Bell’s Palsy and Parkinson’s Disease are some examples of conditions that can lead to dysphagia. 

Stroke: When you have a stroke, blood is not flowing properly to your brain. This is usually the result of either a blood clot or broken blood vessel. Left untreated, this can cause damage to your nervous system — which can lead to difficulty swallowing as well as drooling. 

What Does Treatment Involve?

“Treatment for drooling caused by neurologic disorders can vary based on the cause and degree to which it is impacting your daily life. Some neurologists may refer a patient to a speech-language pathologist. There are also certain medications which can decrease the production of saliva. In addition, Botox injections can be beneficial for some individuals,” Dr. Barry concluded. 

Are you having a problem with drooling?

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