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As far as sleep problems go, nighttime drooling isn't the most medically concerning or embarrassing issue around. Still, kicking off the day with a spit-dampened face isn’t exactly pleasant.

Clinical-level drooling is called sialorrhea, but leaving a small circle of spit on one’s pillow does not a sialorrheac make. A head-sized pool, however, fits the bill. Drooling, per a 2006 study, is defined as “the inability to control oral secretions.” The same paper, authored by a team of oral specialists, disputes the notion that droolers simply churn out too much saliva. Even people who churn out low amounts of mouth juice can drench pillows.

“Drooling of saliva,” the study authors wrote, “appears to be the consequence of the dysfunction in the coordination of the swallowing mechanism, resulting in excess pooling of saliva in the anterior portion of the oral cavity and the unintentional loss of saliva from the mouth.”

A little drool is nothing to sweat, but excessive spit-flow can actually have health consequences, including difficulty chewing food, interference with speech, perioral infections and electrolyte loss.

Some likely offenders: 

Teething Babies

Kids drool when their chompers are coming in. It’s normal. Frozen foods may help stanch the stream, but sugary foods can exacerbate the issue by sparking saliva production. Best bet? Savory popsicles. Who doesn’t love a stick of frozen broccoli?

Those with Parkinson’s Disease

And other nervous system disorders that impair swallowing. They’re particularly susceptible to drooling: In one 2012 study on daytime and nighttime mouth-leakage  in Parkinson’s patients, 58 percent of participants reported nocturnal drooling, a habit exacerbated by sleeping on one’s side. (Conversely, back-sleeping participants drooled less, but at the risk of choking on their saliva during sleep.)

People taking antipsychotics

Sialorrhea is a common side-effect of taking clozapine, an antipsychotic prescribed for schizophrenia and schizoaffective disorder.

Mouth-Breathers

Open mouths are prone to spillage. Why? The nose occasionally needs to outsource breathing duties to the mouth, and it’s totally normal. (What else is a respiratory system to do when congestion clogs up the electric socket of the face?)

But mouth breathing can become an every-night occurrence for people with conditions including tonsillitis, allergic rhinitis, sinusitis and sleep apnea. In all cases, it’s important to treat the underlying medical issue. Sleep apnea sufferers who wake up in spit-puddles should consider changing up their CPAP masks, either by adding on chinstraps or upgrading to full-face masks.

No Mo’ Flow

Okay, so how does one switch off the nozzle, so to speak? Doctors might recommend one of the following treatment options for serious droolers. 

Antimuscarinics, also used to treat overactive bladders and reduce salivation during anesthesia, are in the family of anticholinergic drugs, which block acetylcholine, a neurotransmitter involved in maintaining wakefulness. As a result, anticholinergics have sedative effects.

An insomniac with the spit-stream of a St. Bernard may end up with an antimuscarinic Rx. The FDA approved Cuvposa in 2005 for chronic drooling in children. (Doctors may also hesitate to prescribe anticholinergics due to adverse effects.) A few antidepressants that also block acetylcholine receptors, such as Pristiq, come with reduced salivation. To non-droolers, this means dry mouth. To droolers, less salivation is salvation.

Alpha blockers are muscle relaxants primarily used to regulate or treat blood pressure, prostate function, adrenal gland tumors, and circulatory and autoimmune disorders. In one clinical trial, schizophrenia patients reported on the size of their pillow wet-spots before and after taking the alpha blocker clonidine for one month. The spots shrunk and the meds didn't come with significant adverse effects.

Botox. Wrinkle immobilization may seem like a 21st-century indulgence, but the botulism-saliva connection dates back to 1822. After noting that botulism patients experienced severe dry-mouth, Justinus Kerner, a German poet and doctor, surmised that botulinum toxin could treat hyper-salivation. It only took 185-ish years for doctors to test Kerner’s hypothesis. One 2009 Dutch study found that injecting wrinkle-freezer into the submandibular glands, responsible for about 90 percent of daily saliva output, helped curb drooling in children with neurological disorders.