Excessive yawning and thermoregulation: two case histories of chronic, debilitating bouts of yawning

Brain temperature in healthy and diseased conditions: A review on the special implications of MRS for monitoring brain temperature

Brain temperature determines not only an individual's cognitive functionality but also the prognosis and mortality rates of many brain diseases. More specifically, brain temperature not only changes in response to different physiological events like yawning and stretching, but also plays a significant pathophysiological role in a number of neurological and neuropsychiatric illnesses. Here, we have outlined the function of brain hyperthermia in both diseased and healthy states, focusing particularly on the amyloid beta aggregation in Alzheimer's disease.

Factors affecting yawning frequencies in preterm neonates

Yawning is a long neglected behavioral pattern, but it has recently gained an increasing interdisciplinary attention for its theoretical implications as well as for its potential use as a clinical marker, with particular regard to perinatal neurobehavioral assessment. The present study investigated the factors affecting yawning frequencies in hospitalized preterm neonates (N = 58), in order to distinguish the effects of hunger and sleep-related modulations and to examine the possible impact of demographic and clinical variables on yawning frequencies. Results showed that preterm neonates yawned more often before than after feeding, and this modulation was not explained by the amount of time spent in quiet sleep in the two conditions. Moreover, second born twins, known to be more prone to neonatal mortality and morbidity, showed increased yawning rates compared to first born twins. Overall, our results are consistent with the hypothesis that yawning frequencies in preterm neonates are modulated by separate mechanisms, related e.g. to hunger, vigilance and stress. These findings, although preliminary and based only on behavioral data, might indicate that several distinct neuropharmacological pathways that have been found to be involved in yawn modulation in adults are already observable in preterm neonates.

Yawning and airway physiology: a scoping review and novel hypothesis

Background and purpose

Yawning is a stereotypical complex muscular movement and is commonly executed by most vertebrates. In seconds, the entire airway is fully dilated and surrounding muscles are powerfully stretched, most prominently around the pharynx. To date, yawning has been rarely studied, and as of yet there is no consensus on its main function.

Material and methods

To investigate a mechanical airway function for yawning, a literature search was conducted to relate the frequency of yawning and obstructive airway conditions.

Results

The results show that changes in obstructive airway conditions and alteration of the frequency of yawning are temporally related.

Interpretation

These relationships, however, cannot be interpreted as causal, nor can they be extrapolated to explain the function of yawning. Yet airway management and yawning share many physiological characteristics. We therefore propose a novel hypotheses: yawning plays a significant role in airway physiology by muscle repositioning and widening the airway lumen, thereby securing long-term oxygenation.

Brain size and neuron numbers drive differences in yawn duration across mammals and birds

Recent studies indicate that yawning evolved as a brain cooling mechanism. Given that larger brains have greater thermolytic needs and brain temperature is determined in part by heat production from neuronal activity, it was hypothesized that animals with larger brains and more neurons would yawn longer to produce comparable cooling effects. To test this, we performed the largest study on yawning ever conducted, analyzing 1291 yawns from 101 species (55 mammals; 46 birds). Phylogenetically controlled analyses revealed robust positive correlations between yawn duration and (1) brain mass, (2) total neuron number, and (3) cortical/pallial neuron number in both mammals and birds, which cannot be attributed solely to allometric scaling rules. These relationships were similar across clades, though mammals exhibited considerably longer yawns than birds of comparable brain and body mass. These findings provide further evidence suggesting that yawning is a thermoregulatory adaptation that has been conserved across amniote evolution.

Seeing others yawn selectively enhances vigilance: an eye-tracking study of snake detection

While the origin of yawning appears to be physiologic, yawns may also hold a derived communicative function in social species. In particular, the arousal reduction hypothesis states that yawning signals to others that the actor is experiencing a down regulation of arousal and vigilance. If true, seeing another individual yawn might enhance the vigilance of observers to compensate for the reduced mental processing of the yawner. This was tested in humans by assessing how exposure to yawning stimuli alters performance on visual search tasks for detecting snakes (a threatening stimulus) and frogs (a neutral stimulus). In a repeated-measures design, 38 participants completed these tasks separately after viewing yawning and control videos. Eye-tracking was used to measure detection latency and distractor fixation frequency. Replicating previous evolutionary-based research, snakes were detected more rapidly than frogs across trials. Moreover, consistent with the view that yawning holds a distinct signaling function, there were significant interactions for both detection latency and distractor fixation frequency showing that vigilance was selectively enhanced following exposure to yawns. That is, after viewing videos of other people yawning, participants detected snakes more rapidly and were less likely to fixate on distractor frogs during trials. These findings provide the first experimental evidence for a social function to yawning in any species, and imply the presence of a previously unidentified psychological adaptation for preserving group vigilance.

Experimental evidence for yawn contagion in orangutans (Pongo pygmaeus)

Yawning is highly contagious, yet both its proximate mechanism(s) and its ultimate causation remain poorly understood. Scholars have suggested a link between contagious yawning (CY) and sociality due to its appearance in mostly social species. Nevertheless, as findings are inconsistent, CY’s function and evolution remains heavily debated. One way to understand the evolution of CY is by studying it in hominids. Although CY has been found in chimpanzees and bonobos, but is absent in gorillas, data on orangutans are missing despite them being the least social hominid. Orangutans are thus interesting for understanding CY’s phylogeny. Here, we experimentally tested whether orangutans yawn contagiously in response to videos of conspecifics yawning. Furthermore, we investigated whether CY was affected by familiarity with the yawning individual (i.e. a familiar or unfamiliar conspecific and a 3D orangutan avatar). In 700 trials across 8 individuals, we found that orangutans are more likely to yawn in response to yawn videos compared to control videos of conspecifics, but not to yawn videos of the avatar. Interestingly, CY occurred regardless of whether a conspecific was familiar or unfamiliar. We conclude that CY was likely already present in the last common ancestor of humans and great apes, though more converging evidence is needed.

Manipulating neck temperature alters contagious yawning in humans

The existence of yawning across a diverse array of species has led many researchers to postulate its neurological significance. One hypothesis, which has garnered recent support, posits that yawns function to cool the brain by flushing hyperthermic blood away from the skull while simultaneously introducing a cooler arterial supply. The current study tested this hypothesis by examining how manipulations aimed at modifying carotid artery temperature, which in turn directly alters cranial temperature, influences contagious yawning in humans. Participants held either a warm (46 °C), cold (4 °C) or room temperature (22 °C) pack firmly to their neck, just over their carotid arteries, for a period of five minutes prior to watching a contagious yawning stimulus. Thermographic imaging verified that these manipulations produced predicted changes in temperature at the superomedial orbital area, a region previously used as a noninvasive measure of brain temperature (i.e., the brain temperature tunnel). As predicted by past research, both the urge to yawn and overall yawn frequency significantly diminished in the cooling condition (p < .05). Less than half (48.5%) of the participants in the cooling condition reported the urge to yawn, while this urge was expressed by the vast majority of participants in the warming condition (84.8%). Moreover, there was a threefold difference in the mean number of yawns per participant between the cooling and warming conditions (0.364 compared to 1.121). These findings are consistent with previous research indicating that yawns function as a compensatory brain cooling mechanism.

Thermal imaging reveals sizable shifts in facial temperature surrounding yawning in budgerigars (Melopsittacus undulatus)

Accumulating comparative and interdisciplinary research supports a brain cooling function to yawning. In particular, previous research has shown significant decreases in both brain and skull temperature following yawning in mammals. In a recent study using a thermal imaging camera, significant reductions in both the cornea and concha temperature were observed following yawns in the high-yawning subline of Sprague-Dawley rats. Here, we performed a similar experiment to investigate shifts in facial temperature surrounding yawning in an avian species with more typical yawning patterns: budgerigars (Melopsittacus undulatus). In particular, we took maximal surface temperature recordings from the face (cere or eye) from 13 birds over a one-hour period to track changes before and after yawns. Similar to previous findings in high-yawning rats, we identified significant cooling (-0.36°C) of the face 10-20 seconds following yawning in budgerigars. Consistent with the hypothesis that yawns serve a thermoregulatory function, facial temperatures were slightly elevated just prior to yawning and then decreased significantly below baseline levels immediately thereafter. Similarly, birds that yawned during the trials had consistently higher facial temperatures compared to those that did not yawn. Moreover, yawn latency and overall yawn frequency were strongly correlated with the highest facial temperature recorded from each bird across trials. These results provide convergent evidence in support of a brain cooling function to yawning, and further validate the use of thermal imaging to monitor changes in skull temperature surrounding yawning events.

Yawning, a thermoregulatory mechanism during fever? A study of yawning frequency and its predictors during experimentally induced sickness

Yawning has been proposed to serve both physiological and social functions, the latter likely to have developed later in its evolution. A central hypothesis is that yawning cools the brain but whether yawning is a thermoregulatory mechanism that is activated during hyperthermia (i.e., thermoregulatory failure) or is activated in any instance of brain temperature increase (e.g., also during fever) is unclear and experimental assessments of yawning during fever are lacking. In this study, we determined the effect of experimentally induced fever on yawning frequency. We also explored alternative predictors of yawning during sickness (sleepiness, autonomic nervous system indexes and sickness symptoms). Twenty-two healthy human subjects participated in a randomized, placebo-controlled, cross-over study, where the subjects received an injection of the bacterial endotoxin lipopolysaccharide (LPS) at a dose of 2ng/kg body weight in one condition and placebo in the other. Yawning was scored from video recordings from 30min before to 4h after the injection. Body temperature was measured frequently, alongside with heart rate, blood pressure, nausea and overall sickness symptoms. Yawning frequency was found to significantly increase over time during experimentally induced sickness, but not in the placebo condition. In particular, yawning frequency was increased during the rising phase of body temperature induced by LPS administration, although no significant correlation was found between body temperature increase and yawning frequency. In addition, exploratory analyses showed that a higher yawning frequency was associated with less increase in sickness symptoms and nausea intensity. While the current study adds to previous research showing significant increase in yawning frequency during hyperthermia, further studies are needed if we are to properly characterize the brain cooling role of yawning in humans. The investigation of other functions, such as being a vasovagal inhibitory, may shed stronger light on the functions of yawning.

Yawning reduces facial temperature in the high-yawning subline of Sprague-Dawley rats

BACKGROUND

Yawning is a stereotyped behavior that enhances blood flow to the skull, and the resulting counterflow has been hypothesized as a mechanism for brain cooling. Studies have shown that yawns are strongly associated with physiological and pathological conditions that increase brain temperature, and that they are followed by equivalent decreases in brain temperature. However, measured reductions in cranial or facial temperatures following yawning have yet to be reported, to our knowledge. To accomplish this, we used a subline of Sprague-Dawley rats that yawn at a much greater rate (20 yawns/h) than do outbred Sprague-Dawley rats (2 yawns/h).

RESULTS

Using an infrared camera, we effectively evaluated thermal changes in the cornea and concha of these rats before, during, and after yawns. The maximum temperature in both regions significantly decreased 10 s following yawns (concha: -0.3 °C, cornea: -0.4 °C), with a return to basal temperatures after 20 s.

CONCLUSIONS

This study is the first clear demonstration of yawning-induced thermal cooling on the surface of the face, providing convergent evidence that this behavior plays a functional role in thermoregulation. As other studies have demonstrated that yawning is capable of reducing cortical brain temperature, our current data support the idea that yawning functions as a thermoregulator, affecting all structures within the head.

Yawning induced by focal electrical stimulation in the human brain

The primary function of yawning is not fully understood. We report a case in which electrical stimulation of the putamen in the human brain consistently elicited yawning. A 46-year-old woman with intractable epilepsy had invasive depth electrode monitoring and cortical stimulation mapping as part of her presurgical epilepsy evaluation. The first two contacts of a depth electrode that was intended to sample the left insula were in contact with the putamen. Stimulation of these contacts at 6mA and 8mA consistently elicited yawning on two separate days. Engagement in arithmetic and motor tasks during stimulation did not result in yawning. When considering the role of the putamen in motor control and its extensive connectivity to cortical and brainstem regions, our findings suggest that it plays a key role in the execution of motor movements necessitated by yawning. Furthermore, given the role of the anterior insula in attention and focused tasks, activation of this area while engaged in arithmetic and motor tasks could inhibit the putaminal processing necessary for yawning. Many have hypothesized the function of yawning; however, it remains debatable whether yawning serves a primarily physiological or communicative function or perhaps both.

A thermal window for yawning in humans: yawning as a brain cooling mechanism

The thermoregulatory theory of yawning posits that yawns function to cool the brain in part due to counter-current heat exchange with the deep inhalation of ambient air. Consequently, yawning should be constrained to an optimal thermal zone or range of temperature, i.e., a thermal window, in which we should expect a lower frequency at extreme temperatures. Previous research shows that yawn frequency diminishes as ambient temperatures rise and approach body temperature, but a lower bound to the thermal window has not been demonstrated. To test this, a total of 120 pedestrians were sampled for susceptibly to self-reported yawn contagion during distinct temperature ranges and seasons (winter: 1.4°C, n=60; summer: 19.4°C, n=60). As predicted, the proportion of pedestrians reporting yawning was significantly lower during winter than in summer (18.3% vs. 41.7%), with temperature being the only significant predictor of these differences across seasons. The underlying mechanism for yawning in humans, both spontaneous and contagious, appears to be involved in brain thermoregulation.

The thermoregulatory theory of yawning: what we know from over 5 years of research

Over the past 5 years numerous reports have confirmed and replicated the specific brain cooling and thermal window predictions derived from the thermoregulatory theory of yawning, and no study has found evidence contrary to these findings. Here we review the comparative research supporting this model of yawning among homeotherms, while highlighting a recent report showing how the expression of contagious yawning in humans is altered by seasonal climate variation. The fact that yawning is constrained to a thermal window of ambient temperature provides unique and compelling support in favor of this theory. Heretofore, no existing alternative hypothesis of yawning can explain these results, which have important implications for understanding the potential functional role of this behavior, both physiologically and socially, in humans and other animals. In discussion we stress the broader applications of this work in clinical settings, and counter the various criticisms of this theory.

Propranolol in yawning prophylaxis: a case report

OBJECTIVE

Yawning is a frequent behavior with circadian effects. Sometimes, its frequency is very high and it is disturbing. However, there is no evidence-based treatment for yawning.

METHOD

This is a case report of a man with severe yawning from about 2 years ago.

RESULTS

Yawning reduced after taking propranolol.

CONCLUSION

Current evidence suggests that propranolol may decrease yawning through its thermoregulation effect. It is worthwhile conducting controlled clinical trials to study whether propranolol is an effective treatment for yawning.

Human paranasal sinuses and selective brain cooling: a ventilation system activated by yawning?

The function of the paranasal sinuses has been a controversial subject since the time of Galen, with many different theories advanced about their biological significance. For one, the paranasal sinuses have been regarded as warmers of respiratory air, when in actuality these structures appear to function in cooling the blood. In fact, human paranasal sinuses have been shown to have higher volumes in individuals living in warmer climates, and thus may be considered radiators of the brain. The literature suggests that the transfer of cool venous blood from the paranasal sinuses to the dura mater may provide a mechanism for the convection process of cooling produced by the evaporation of mucus within human sinuses. In turn, the dura mater may transmit these temperature changes, initiated by the cool venous blood from the heat-dissipating surfaces of the sinuses, to the cerebrospinal fluid compartments. Furthermore, it has recently been demonstrated in cadaveric dissections that the thin bony posterior wall of the maxillary sinus serves as an origin for both medial and lateral pterygoid muscle segments, an anatomic finding that had been previously underappreciated in the literature. The present authors hypothesize that the thin posterior wall of the maxillary sinus may flex during yawning, operating like a bellows pump, actively ventilating the sinus system, and thus facilitating brain cooling. Such a powered ventilation system has not previously been described in humans, although an analogous system has been reported in birds.

Why do we yawn? The importance of evidence for specific yawn-induced effects

Gallup (this issue) believes that our recent review on the function of yawning (Guggisberg et al., 2010) is unbalanced and that it ignores evidence for his thermoregulation hypothesis. Here we address these criticisms and show them to be untenable. While we never claimed that the social hypothesis of yawning has "definite experimental support", we emphasize the importance of experimental evidence for specific effects of yawns when considering why we yawn. The only specific effect of yawning that could be demonstrated so far is its contagiousness in humans, some non-human primates, and possibly dogs, whereas all studies investigating physiological consequences of yawns were unable to observe specific yawn-induced effects in the individual of any species. The argument that from an evolutionary perspective, yawns must have a "primitive" physiological function arises from imprecise reasoning.

Yawning and stretching predict brain temperature changes in rats: support for the thermoregulatory hypothesis

Recent research suggests that yawning is an adaptive behavior that functions to promote brain thermoregulation among homeotherms. To explore the relationship between brain temperature and yawning we implanted thermocoupled probes in the frontal cortex of rats to measure brain temperature before, during and after yawning. Temperature recordings indicate that yawns and stretches occurred during increases in brain temperature, with brain temperatures being restored to baseline following the execution of each of these behaviors. The circulatory changes that accompany yawning and stretching may explain some of the thermal similarities surrounding these events. These results suggest that yawning and stretching may serve to maintain brain thermal homeostasis.