Struggling with Excessive Saliva at Night: Which Specialist to Consult? - Psychiatry

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Excessive saliva production at night can be a frustrating and uncomfortable issue, especially when it interferes with sleep. It sounds like you've been dealing with this problem for a while, and it's understandable that you're seeking answers. Based on your description, there are several potential causes for your symptoms, and consulting the right specialist is crucial for effective management.

1. Understanding the Symptoms: Excessive saliva production, also known as hypersalivation, can occur for various reasons. It may be related to underlying medical conditions, medications, or even anxiety. The sensation of something being stuck in your throat, as you described, could indicate a condition known as globus sensation, which is often associated with anxiety or gastroesophageal reflux disease (GERD).
2. Potential Causes:
- Neurological Issues: Conditions affecting the nervous system can lead to changes in saliva production. If you have a history of neurological problems, this might be a consideration.

- Gastroesophageal Reflux Disease (GERD): This condition can cause irritation in the throat and lead to increased saliva production as a protective mechanism.

- Medications: Some medications can cause dry mouth or excessive salivation as a side effect. If you are on any medications, it would be worth reviewing them with your physician.

- Oral Health Issues: Dental problems or infections can also lead to increased saliva production.
3. Which Specialist to Consult: Given that you've already seen multiple specialists, including pulmonologists, ENT (ear, nose, and throat) doctors, and gastroenterologists, it might be beneficial to consider a few additional options:
- Oral and Maxillofacial Surgeon: They can evaluate any structural issues in your mouth or throat that may contribute to your symptoms.

- Neurologist: If there is a suspicion of a neurological cause, a neurologist can perform further evaluations.

- Psychiatrist or Psychologist: Since anxiety can exacerbate physical symptoms, consulting a mental health professional might help address any underlying anxiety that could be contributing to your hypersalivation and globus sensation.

4. Management Strategies: While you seek a diagnosis, there are some strategies you can try to manage your symptoms:
- Sleep Position: Experimenting with different sleeping positions may help reduce saliva pooling.

- Hydration: Staying well-hydrated during the day can help manage saliva production at night.

- Relaxation Techniques: Stress management techniques such as deep breathing, meditation, or yoga may help alleviate anxiety and improve your overall comfort.

5. Follow-Up: It’s essential to keep a record of your symptoms, including when they occur, their severity, and any associated factors (like diet or stress levels). This information can be invaluable for any healthcare provider you consult.

In conclusion, while excessive saliva production at night can be distressing, identifying the underlying cause is key to finding relief. Given your ongoing symptoms and the various specialists you've already consulted, I recommend seeking a comprehensive evaluation from a specialist who can look at the interplay between your throat issues and saliva production. A multidisciplinary approach may be necessary to address both the physical and psychological aspects of your symptoms.