Dry mouth at night: Symptoms, causes, and treatments

In this article:

• Symptoms of dry mouth at night
• Causes of dry mouth at night
• Treatments for dry mouth at night
• When to see a doctor for dry mouth

In this article

• Symptoms of dry mouth at night
• Causes of dry mouth at night
• Treatments for dry mouth at night
• When to see a doctor for dry mouth

Waking up in the middle of the night or in the morning with a dry mouth is not an uncommon occurrence. A dry mouth occurs when the salivary glands in the mouth do not make enough saliva. Saliva, or spit, is crucial because it breaks down food, washes away food particles, helps with swallowing, keeps teeth strong, and fights tooth decay. Having an unusually dry mouth is a problem that can be due to many causes, including medication side effects, certain health conditions, or sleeping with the mouth open. Although having a dry mouth, or xerostomia, can be uncomfortable, the good news is that there are ways to treat it. 

Symptoms of dry mouth at night

Dry mouth at night symptoms may include:

• Dryness
• Saliva that feels thick or stringy or builds up
• Throat feels dry and or sore
• Dry, chapped lips
• Waking up due to difficulty breathing through the mouth from dryness
• Waking up frequently and needing to drink water
• Bad morning breath

Dry mouth at night symptoms may include:

• Difficulty chewing
• Difficulty swallowing
• Difficulty speaking
• Altered taste sensations
• Bad taste in the mouth
• Hoarse voice
• Discomfort wearing dentures

Causes of dry mouth at night

There are various causes of a nighttime dry mouth. Causes may be due to medical or lifestyle reasons and can include:

Dehydration

Dry mouth can occur as a result of dehydration. Dehydration occurs when less water is taken into the body than the body gets rid of through urine, sweat, and other ways. Dehydration can also occur when losing more fluid than taking in occurs. This can happen during severe diarrhea or excessive sweating in hot weather. Some medical conditions, such as diabetes, can also cause dehydration. 

Mouth breathing

Breathing through the mouth (instead of the nose) while sleeping can lead to a dry mouth. A sleep specialist can often treat this condition. 

Medications

Many different drugs can cause dryness as a side effect. When taking more than one medicine that causes a dry mouth, the risk of a dry mouth increases. Medications that can cause a dry mouth include, but are not limited to:

• Antihistamines for allergies like Benadryl (diphenhydramine) or Zyrtec (cetirizine)
• Decongestants like Sudafed (pseudoephedrine)
• Antidepressants such as Elavil (amitriptyline) or Lexapro (escitalopram)
• Antipsychotics such as Risperdal (risperidone)
• Muscle relaxants such as Zanaflex (tizanidine)
• Diuretics (“water pills”) such as hydrochlorothiazide (HCTZ) or Lasix (furosemide)
• Stimulants that treat attention-deficit/hyperactivity disorder (ADHD) like Adderall (mixed amphetamine salts)
• Overactive bladder medications such as Vesicare (solifenacin) or Detrol (tolterodine)
• Anti-anxiety medicines like Valium (diazepam) or Xanax (alprazolam)
• Parkinson’s disease medications like Cogentin (benztropine)

RELATED: 12 medications that cause dry mouth (and how to treat it)

Medical Treatments

Medical treatments, such as cancer radiation treatment of the head and neck, can cause dry mouth. People who use a continuous positive airway pressure (CPAP) machine to treat obstructive sleep apnea also frequently experience dry mouth. 

Medical conditions

A dry mouth can also occur due to a medical condition or illness. Examples include:

• Sjögren’s syndrome 
• Obstructive sleep apnea
• Diabetes
• COVID-19
• HIV
• Hypertension (high blood pressure)
• Hepatitis C

Smoking

Smoking can cause decreased saliva production, leading to a dry mouth. 

Aging

While a dry mouth is not part of the aging process, older people tend to take more medications that cause dry mouth. 

Treatments for dry mouth at night

Treating the underlying cause

If symptoms of a dry mouth are occurring, consult a healthcare professional. If an underlying cause of dry mouth can be pinpointed, it may be possible to fix the cause, which will then alleviate symptoms of dry mouth. For example, if taking a medication that causes dry mouth, initiate a conversation with a healthcare professional to find out if there is a medication to take that is just as effective but without the side effects of a dry mouth. Pharmacists are also qualified to review medication profiles and see which, if any, of current medications being taken may be contributing to dry mouth symptoms

Lifestyle changes and home remedies to relieve and prevent dry mouth

Here are some things that can be done to help relieve symptoms of a dry mouth—as well as to help prevent nighttime dry mouth.

• Dry mouth sufferers should drink plenty of water throughout the day. Carry a water bottle to help with fluid intake. Water intake can also be increased by sipping water in between bites when eating. Also, try to choose foods that have high water content like soups, vegetables such as cucumbers, and fruit like watermelon. Cucumber and melon slices can be frozen and placed between the cheek and gum to increase hydration. 
• Additionally, filling a spray bottle with water and spraying it in the mouth occasionally can help relieve dry mouth. 
• Use a cool-mist humidifier in the bedroom to add moisture to dry air. Carefully follow the manufacturer’s guide for use and cleaning to prevent mold and bacteria from growing. 
• Suck on sugarless candy or lozenges or chew sugar-free gum to increase saliva production. Always choose sugar-free options over candies and gums that contain sugar. 
• Avoid (or limit) caffeine, tobacco, and alcohol use. All of these can cause a dry mouth. 
• Choose a mouthwash that is moisturizing as well as alcohol-free.
• Avoid spicy, acidic, and sugary foods at night.
• Try acupuncture for help with dry mouth symptoms. 

Medications

Consult a healthcare professional for medical advice on medications for dry mouth. Some over-the-counter products that may help a dry mouth include:

• Nasal strips that open the nostrils for better breathing
• Saliva substitute sprays or drops
• Nasal rinse to help keep the nasal passages moist, which can help relieve a dry mouth

Prescription medications for dry mouth include:

• Evoxac (cevimeline): This medication is FDA approved for dry mouth associated with Sjögren’s syndrome. Cevimeline is an oral capsule that is taken by mouth three times daily. It works by increasing salivary gland secretion. Common side effects include excess sweating, nausea, vomiting, and symptoms of upper respiratory infection. 
• Salagen (pilocarpine): This medicine is FDA approved for dry mouth associated with Sjögren’s syndrome or due to head and neck cancer treatment. This medicine works by increasing salivary gland secretion. For dry mouth associated with Sjögren’s syndrome, pilocarpine is usually taken four times daily, with full effects taking up to six weeks. Pilocarpine is generally taken three times daily for dry mouth associated with cancer treatment. Pilocarpine is typically taken three times daily. It may take up to three months to see the full effects of this medicine. Common side effects include sweating, chills, nausea, flushing, runny nose, and frequent urination.
• Amifostine: This medication can be given intravenously (into a vein) before radiation in individuals with dry mouth due to head and neck radiation treatment. 

When to see a doctor for dry mouth

Not everyone who has a dry mouth will need to see a healthcare provider. An occasional case of dry mouth is rarely a cause for worry. Home remedies and lifestyle changes like increasing water intake, using a humidifier, and limiting caffeine can alleviate symptoms. 

However, see a healthcare professional if:

• Home remedies and lifestyle changes do not help dry mouth symptoms
• Dry mouth is severe and or does not go away
• Dry mouth affects sleep 
• Other symptoms, like dry eyes or enlarged salivary glands, are occurring

A dry mouth can lead to complications like tooth decay and cavities, so talk to a dentist about oral care. A dentist plays a vital role in oral health. Ask about the best ways to prevent damage to the teeth, such as topical fluoride, alcohol-free mouthwash, and regular cleaning and checkups.