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Yawning may signal an impending migraine attack calling for a prompt action
Yawning which is considered to be a symptom that reflects dopaminergic activity is repetitively seen in some patients during migraine attacks. Dr.Bulent Guven of Department of Neurology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey, and colleagues conducted a cross-sectional study is to investigate the frequency of yawning during migraine attacks and its association with different characteristics of a migraine.The researchers found that in patients with a migraine, repetitive yawning may accompany or precede a migraine attack calling for a prompt action.The results of the study have been published in Headache -The Journal of Head and Face Pain.
In the study, researchers evaluated patients with a migraine with or without aura using questionnaires and diaries to determine the characteristics of a headache and accompanying symptoms. The also determined repetitive yawning in the premonitory phase and/or during a headache.
In all three hundred and thirty-nine patients were included in the study out of which one hundred and fifty-four patients reported repetitive yawning (45.4%) during migraine attacks. Repetitive yawning was reported in the 11.2% of the patients in the premonitory phase, 24.2% during headaches, and 10% both in the premonitory phase and during headaches. Migraine with aura (46.8 vs 31.9%; P = .005), accompanying nausea (89.6 vs 75.1%; P = .001), vomiting (48.7 vs 37.8%; P = .044), osmophobia (66.7 vs 52.3%; P = .024), and cutaneous allodynia (58.2 vs 46%; P = .032) were more common in patients with yawning than without. Other dopaminergic-hypothalamic premonitory symptoms (41.6 vs 26.5%; P = .003), especially sleepiness (17.5 vs 5.9%; P = .001), irritability/anxiety (21.4% vs 11.4%; P = .019), nausea/vomiting (10.4 vs 4.3%; P = .03), and changes in appetite (18.2 vs 9.7%; P = .024), were also more frequent in patients with yawning than without. After being adjusted for all other relevant covariates, the odds of repetitive yawning were increased by the presence of nausea (OR 2.88; 95% CI 1.453-5.726; P = .002) and migraine with aura (OR 1.66; 95% CI 1.035-2.671; P = .036).
The researchers concluded that their results demonstrated that yawning is a common self-reported symptom leading or accompanying migraine attacks and is associated with aura, nausea and/or vomiting, osmophobia, and cutaneous allodynia in patients with a migraine. Although yawning is a rather frequently seen behavior, it is a unique and reliable symptom in patients with a migraine that may offer an opportunity for early treatment of migraine attacks.
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