By Brandon Peters, MD 

 Medically reviewed by Daniel Combs, MD

A dry throat at night isn't usually due to an underlying problem, especially if it only happens occasionally. But if your mouth or throat feels dry at night for an extended period of time, it could be a sign of an underlying issue, such as mouth breathing, allergies, or sleep apnea.

This article explains more about the causes of dry throat and mouth at night, how it's treated, and how to prevent it from happening.

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Caiaimage / Tom Merton / Getty Images

Symptoms

One of the main symptoms of dry mouth during sleep (also called xerostomia) is feeling thirsty at night, which can range from a relatively minor thirst to an extreme one.

In addition to a dry tongue and throat, you may notice other symptoms, like:

  • Mouth soreness

  • Dry, cracked lips

  • Bad breath (halitosis)

  • A difference in how things taste

  • Trouble speaking and swallowing

Dry mouth can also increase the risk of developing mouth infections, cavities, and gingivitis. This is because saliva helps wash away food particles and reduce harmful germs.

Causes

Several factors may contribute to dry mouth and throat at night. They range from medication side effects to sleep or health conditions.

Medications

One of the more common causes of thirst at night is using medications that cause dryness.

These can include:

  • Diuretics like Lasix (furosemide)

  • Blood pressure medications

  • Medications for treating peripheral edema (swelling in the feet)

  • Heart failure medication

  • Anticholinergic medications

  • Antidepressants like amitriptyline or nortriptyline

  • Sleeping pills that contain diphenhydramine

  • Antihistamines for allergies, such as Claritin

Mouth Breathing

Many people experience dry mouth and dry throat at night simply because they are breathing through their mouth when they sleep. Mouth breathing more likely occurs when the nasal passages are blocked.

This kind of congestion can happen with:

  • Colds

  • Allergies

  • Structural problems such as a deviated nasal septum or enlarged turbinates

By default, you breathe through your nose. Nasal breathing reduces the loss of moisture from the soft tissues that line your airways. However, when you breathe through your mouth, the movement of air quickly dries you out.

Allergies

Seasonal allergies can cause symptoms like sneezing and nasal congestion, which might lead you to breathe out of your mouth instead of your nose while you sleep.

Antihistamines offered to combat allergies, such as Claritin (loratadine) and Allegra (fexofenadine), may also dry your mouth out. This is a consequence of the medication working to clear the nasal passage by drying out mucus.

Dehydration

You might wake up with a dry throat if you're dehydrated. This means that your body is releasing more water than it's taking in. This can happen when you're not drinking enough fluids or if you're releasing more fluids than usual, either because you're sweating a lot or having diarrhea.

Snoring

People often snore because there is something partially obstructing the upper airway, including the nose and throat. This can lead to mouth breathing, which is a main cause of dry mouth and throat at night.

Sleep Apnea

This is another indirect cause of dry mouth. Obstructive sleep apnea occurs when there's a blockage in the upper airway. It can lead to mouth breathing, which can in turn lead to a dry mouth and a dry throat.

Other symptoms of sleep apnea include chronic snoring, choking or gasping while asleep, teeth grinding or clenching, and night sweats.

Needing to drink water at night may be an early sign that you cannot breathe well while you sleep.

GERD

Gastroesophageal reflux disease (GERD) is a condition that causes stomach acid to flow backwards into the esophagus. People with GERD often experience dry mouth and dry throat and may also have related symptoms such as the vague sensation that something is stuck in the throat.

Lying down can make GERD symptoms worse, which is why you may experience dry mouth and throat at night and upon awakening. If you have GERD, you may be able to improve nighttime symptoms by sleeping on a wedge pillow and avoiding food for at least four hours before bedtime.

Sjögren’s syndrome

Sjögren’s syndrome is an autoimmune disease that causes dry mouth and dry eyes. In people with this condition, the immune system mistakenly attacks the glands that produce saliva and tears.

People with Sjögren’s syndrome often report dry throat along with dry mouth, dry nose, swallowing problems, and eye irritation. The sensation of dry throat and mouth may cause you to wake up frequently during the night to drink water.

If you have Sjögren’s syndrome, it may help to keep a humidifier in your room at night.

Mononucleosis

Mononucleosis is usually caused by the Epstein-Barr virus. One of the first symptoms of this infection may be a dry, scratchy throat. As the condition progresses, you may also develop:

  • Fever

  • Body aches

  • Swollen lymph nodes

  • Headache

  • Fatigue

Infection with the Epstein-Barr virus has been associated with the development of Sjögren’s syndrome.

Diabetes

Diabetes can affect saliva production in a number of ways. People with diabetes may experience dehydration and dry mouth because of an increase in urination, or because of inflammation and irritation in the mouth. 

A decrease in the production of saliva can cause dry mouth and throat overnight or upon waking up in the morning.

Asthma

People with asthma are more likely to breathe through their mouths when the condition causes restricted airflow. This can lead to dry mouth and throat.

The use of an inhaler can make dry mouth worse. Beta-2 agonists in rescue inhalers can reduce the flow of saliva over time, leading to dry mouth. Beta-2 agonists and other bronchodilators may also relax the esophageal sphincter, leading to gastroesophageal reflux. Reflux can exacerbate dry mouth and throat symptoms.

Radiation Treatment

Radiation treatment for head and neck cancer may damage the salivary glands. Between 95% and 100% of people who had this treatment will go on to develop dry mouth as a result.

Treatment for radiation-induced xerostomia usually involves the use of medications that stimulate the production of saliva.

Treatment

Treating mouth and throat dryness may involve strategies that both stimulate saliva flow and ensure proper airflow through the nose.

Home Remedies


There are certain things you can do at home to help with dry mouth at night. These include:

  • Chewing sugarless gum to stimulate saliva flow

  • Drinking enough water

  • Consuming less caffeine, which can be dehydrating

  • Avoiding tobacco and alcohol

  • Using a humidifier in your bedroom

When to See a Healthcare Provider

Speak with your healthcare provider if you:

  • Have dry mouth that isn't going away

  • Have trouble swallowing

  • Have a burning sensation in your mouth

  • Have white patches in your mouth

Your doctor will perform a physical exam and take a medical history to determine whether you may have a health condition contributing to your dry mouth. Depending on the diagnosis, your healthcare provider may recommend:

  • Over-the-counter mouth moisteners such as Biotène

  • Allergy treatment that won't dry you out

  • Surgery to repair structural abnormalities such as a deviated septum

  • CPAP for sleep apnea

Prevention

You can take action to prevent your mouth from drying out at night. Some strategies include:

  • Sleeping with a humidifier: This adds moisture to the air to prevent the airways and mouth from drying out.

  • Drinking plenty of fluids: Drinking water and other sugarless drinks can keep you hydrated so that you have adequate saliva flow during sleep. It's especially important to drink fluids if you've been sweating a lot.

  • Avoiding caffeine and alcohol at night: These substances are diuretics, which means they dehydrate you.

  • Not smoking or quitting if you've already started: Smoking can also have a dehydrating effect on the body, which can lead to dry mouth.

  • Reviewing medications: Speak to your healthcare provider about potential side effects of your medications and alternative ones if a drug you are taking causes dry mouth.

  • Using nasal strips: Nasal strips can open up your nasal passage so that you don't have to breathe through your mouth, a main cause of dry mouth.

  • Treating allergies: Try to avoid situations that cause allergy flare ups, or take medications that can suppress symptoms without causing dry mouth.

Summary

Dry throat and dry mouth at night can have unpleasant effects, including cracked lips, bad breath, mouth and tooth infections, and difficulty talking or swallowing.

A range of factors may cause dry mouth, including some health conditions and sleep apnea. Certain medications may also have a side effect of dry mouth. Treatment depends on the cause.

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By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.