At some point or another, most people have woken up to a wet pillow or dry saliva on their chin or cheek. Drooling in your sleep can be embarrassing, but it usually isn’t a sign of any health problems. Drooling in your sleep sometimes means you had a deep, refreshing rest.

When drooling happens frequently, you might wonder if it’s a sign of a medical condition or a medication side effect. You might also ask if it puts you at risk for any medical conditions. Diabetes isn’t a direct cause of nighttime drooling, and drooling doesn’t directly put you at risk for diabetes. However, the two can be related in some ways. In this article, we’ll explore the possible connections between diabetes and the tendency to drool while you sleep.

Why People Sometimes Drool as They Sleep

Drooling in your sleep is relatively common. For most people, it only happens sometimes. People drool when they produce too much saliva or spit or when they have trouble keeping saliva in their mouth for any reason.

Just as babies drool because they haven’t developed full control over the muscles around their mouths, you might drool in your sleep because you’re not able to consciously control those muscles.

People with diabetes may drool in their sleep due to health issues that arise when their diabetes is uncontrolled or not yet diagnosed.

In general, your mouth produces more saliva during the day than at night. However, several factors can cause otherwise healthy people to drool from time to time while they sleep:

• Your sleeping position — When you sleep on your stomach or side, gravity can pull saliva out of your mouth and down your cheek or onto the pillow.
• Sleeping with your mouth open — Some people tend to breathe through the mouth at night.
• Eating lots of acidic foods — Certain foods, like sour or acidic foods, can temporarily trigger excessive saliva production.
• Nasal congestion — If your sinuses are blocked because of allergies or a cold, you might breathe through your mouth at night and drool more as you sleep.
• Gastroesophageal reflux disease (also called acid reflux) — Excess salivation can result from acid reflux. You may have silent reflux, where acid affects your throat or mouth but doesn’t cause heartburn.

Sometimes, the solution to nighttime drooling is as simple as sleeping on your back or wearing mouth tape to bed. However, talk with your healthcare provider before you try mouth taping. It might not be safe if you live with sleep apnea or have a very stuffy nose.

How Uncontrolled Diabetes Can Lead To Drooling

Drooling in your sleep isn’t a typical sign of diabetes. It might even seem unlikely since thirst is a common early symptom of diabetes.

People with diabetes may drool in their sleep frequently because of the health issues that arise when their diabetes is uncontrolled or not yet diagnosed. Otherwise, you might have a condition that commonly appears with diabetes and contributes to drooling in your sleep.

Nerve Damage

Diabetic neuropathy (nerve damage) is a complication that affects up to 50 percent of people living with diabetes. This most likely happens because of high glucose (blood sugar) and high triglycerides. Neuropathy develops slowly and affects the way your nerves function, often causing numbness or pain. Many people say their neuropathy is more noticeable at night.

More than 30 percent of people living with diabetes experience a type of nerve damage called autonomic neuropathy, which affects the nerves that control automatic body functions like blood pressure, breathing, and digestion. Autonomic neuropathy can cause you to have trouble swallowing. When you have trouble swallowing, saliva can build up in your mouth and cause you to drool in your sleep.

Mouth Infections

Uncontrolled diabetes can cause frequent infections, including mouth infections. Any dentist will tell you that sugar is bad for your oral health. Bacteria feed on sugar and can build up on your teeth and gums to cause gum disease and cavities.

When you have uncontrolled diabetes, your saliva may have higher levels of sugar. Combined with the fact that high blood sugar weakens the white blood cells that fight infections, this makes you prone to frequent and long-lasting mouth infections, which can lead to trouble swallowing. When you have difficulty swallowing, you might have trouble getting rid of the saliva your mouth produces and drool a little at night. You may also drool if your body produces extra saliva to compensate for your dry mouth.

A DiabetesTeam member asked, “Is having dry mouth at nighttime a symptom of type 2 diabetes?” Another member described their experience with dry mouth and drooling: “I have the opposite problem — too much saliva, but my mouth still feels dry.”

“I was diagnosed with sleep apnea six months ago — I’m on the CPAP, and it’s changed my life for the better completely.”

— A DiabetesTeam member

Dry mouth in diabetes can also contribute to mouth infections. Saliva helps protect your mouth from germs. Too little saliva can invite fungi into the mouth, which can cause fungal mouth infections like oral thrush. Difficulty swallowing is a common symptom of oral thrush.

Some infections near the mouth, like tonsillitis (a tonsil infection), can more directly cause drooling during sleep.

Sleep Apnea

Research suggests that between 55 percent and 86 percent of people living with type 2 diabetes have obstructive sleep apnea (OSA). This is a sleep disorder that interrupts your breathing while you sleep due to a blocked airway. Having OSA can also increase your risk of developing type 2 diabetes.

You might not notice pauses in your breathing while sleeping, but you might observe other symptoms of OSA. These can include trouble sleeping through the night, having headaches, or feeling tired during the day. OSA can lead to mouth breathing, which can raise the chances of saliva leaving your mouth as you sleep.

Fortunately, getting the right treatment for sleep apnea can help. “I was diagnosed with sleep apnea six months ago,” one DiabetesTeam member shared. “I’m on the CPAP, and it’s changed my life for the better completely.”

Drooling as a Medication Side Effect

Drooling in your sleep might not be a direct side effect of your diabetes medication, but it might result from a common side effect.

For example, a healthcare professional might prescribe metformin to help lower your blood sugar if you have type 2 diabetes. Diarrhea, nausea, and an upset stomach are common side effects of metformin. Some people experience indigestion or heartburn, which can make acid reflux worse. It might go away as you adjust to taking metformin. If you have acid reflux for a long time, the condition is called gastroesophageal reflux disease (GERD).

If you wake up to a wet pillow often, let your doctor know. They might be able to help you find the cause and stop or reduce the drooling.

Acid reflux or GERD can involve heartburn, a sour taste in your mouth, and trouble swallowing. When acid from your stomach irritates the esophagus (the tube connecting your throat to your stomach), your body might respond to the irritation by producing more saliva. These GERD symptoms might lead you to drool in your sleep. Acid reflux is also more likely if you’re living with a hiatal hernia (when the upper part of your stomach slides up through the diaphragm and into your chest).

When To Seek Medical Advice

Nighttime drooling isn’t always a sign of a diabetes complication or medication side effect. If you only drool in your sleep every once in a while, you might not need to mention it to your doctor. But in some cases, your healthcare provider might be able to help.

When Drooling Happens Often

If you wake up to a wet pillow often, let your doctor know. They might be able to help you find the cause and stop or reduce the drooling. Changing sleeping positions, wearing a mouth appliance, and botulinum toxin injections for excessive drooling are all treatment options that might help with drooling in your sleep.

When Drooling Comes With Other Symptoms

You should also let your doctor or sleep medicine specialist know if you’ve noticed drooling at night alongside other possible warning signs of diabetes or common diabetes complications. Your doctor will want to know if you:

• Feel tired a lot
• Need to pee more than usual
• Feel tingling in your hands and feet
• Have a burning sensation in your hands and feet
• Are thirsty all the time
• Lose weight unexpectedly

If your drooling is related to a diabetes complication or any other risk factors, your doctor might suggest diet or lifestyle changes to help you manage your diabetes or adjust your medications.

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