Ross Hauser, MD

Yawning is familiar. We do it when we are tired, bored, or transitioning between sleep and wakefulness. What feels less familiar is yawning repeatedly when there is no obvious reason, especially when it begins alongside headaches, dizziness, head pressure, or difficulty thinking clearly.

At the Hauser Neck Center, some patients describe excessive yawning as one part of a broader symptom pattern. Our clinical interest includes whether cervical structural problems and altered venous drainage could contribute in selected circumstances. This is a proposed connection, not a diagnosis that can be established by counting yawns.

The starting point is broader: yawning has normal physiological roles, and increased yawning can accompany sleep problems, medication effects, migraine, and some neurological conditions. Understanding the context is more useful than assuming that every unexplained yawn signals a serious brain disorder.

Watch the presentation: excessive yawning and neurological symptoms

In this presentation, Dr. Hauser explains the movements involved in a yawn, discusses changes in breathing and autonomic activity, and considers why some patients with neck symptoms also report unusual yawning. He proposes that impaired jugular drainage could affect brain physiology and contribute to symptoms in a subset of patients.

That explanation should be distinguished from established neurological associations and from what a particular patient’s symptoms demonstrate. The video does not establish that excessive yawning reliably diagnoses high intracranial pressure, elevated brain temperature, or cervical instability.

What happens during a yawn?

A yawn is a coordinated motor pattern rather than simply a large breath. It generally involves a prolonged inspiration, wide opening of the mouth, movements of the tongue and throat, and a shorter expiration. Facial, jaw, respiratory, and sometimes neck muscles participate. Stretching may occur with it.

Early experimental work described yawning as a stereotyped action pattern: its recognizable sequence tends to repeat. That work also helped establish that yawning can be triggered by seeing or thinking about another person yawning. (1)

A physiological review describes several proposed functions, including changes in arousal, airway mechanics, pressure equalization, and thermoregulation. No single explanation accounts for every aspect of yawning in every setting. Its occurrence across many vertebrate species also suggests that it is more than a social expression of boredom. (2)

The coordinated movements involve multiple neural pathways. The fact that cranial nerves participate does not mean that a person who yawns frequently has a cranial-nerve injury.

Is yawning the body’s way of getting more oxygen?

The transcript challenges the familiar idea that yawning simply brings in needed oxygen. Experimental research found that breathing oxygen or carbon-dioxide-enriched gases did not significantly change yawning, and exercise that increased breathing did not increase yawning in the same way. This argues against a simple oxygen-deficiency explanation. (3)

Yawning is therefore not a substitute for measuring oxygen levels when medically indicated. Breathlessness, chest pain, or blue discoloration should not be explained away as a need to yawn more.

Newer research: yawning remains a behavior with several proposed functions

A 2025 review revisits yawning’s physiology, evolutionary context, and behavioral features. It discusses several explanations rather than identifying one proven purpose. This supports retaining the useful ideas in the presentation while recognizing that yawning is still an active research topic. (4)

What counts as excessive or pathological yawning?

The important change may be frequency, repeated clusters, interference with activities, or a clear departure from the person’s usual pattern. The term pathological yawning is generally used for unusual or excessive yawning that is not adequately explained by ordinary triggers such as fatigue or boredom.

The video mentions very high rates reported in some disorders. Such examples illustrate how disruptive yawning can become; they are not universal diagnostic thresholds. There is no yawning count that, by itself, identifies intracranial hypertension or determines which investigation is needed.

A useful distinction is whether yawning accompanies sleepiness, occurs in stereotyped episodes with other neurological changes, follows a medication change, or appears during a migraine or fainting episode. These patterns lead to different questions.

Common explanations deserve attention first

Note: Withdrawal-related yawning is particularly recognized with opioids; different substances have different withdrawal patterns. It is not a reliable indicator that the body is clearing toxins. Medication-related yawning also does not justify stopping a prescribed drug abruptly. A temporal association is useful information, but medication changes require appropriate clinical guidance.

Yawning, autonomic changes, and alertness

The presentation describes temporary changes in lung volume, heart rate, and autonomic activity during yawning. A physiological study measured changes around yawns, supporting the view that yawning involves more than mouth opening. Those observations do not demonstrate that yawning resets the entire autonomic nervous system. (5)

A brief sensation of increased alertness after a yawn is also different from restoring safe wakefulness. Repeated yawning while driving may accompany dangerous sleepiness. A yawn should not be relied on to prevent falling asleep at the wheel. Contagious yawning is an interesting behavioral phenomenon, but the presence or absence of it is not an individual test of empathy, personality, intelligence, or brain health.

Can excessive yawning indicate neurological disease?

Yes, it can occur in neurological conditions, but it is not specific to one condition. A neurological review discusses altered yawning in settings that include stroke, demyelinating disease, epilepsy, migraine, and medication exposure. It also describes yawning around vasovagal symptoms and in other clinical contexts. (6)

This is an association to interpret alongside the history and examination. It does not mean that neurological disease is the most likely explanation for every person who yawns frequently.

The original case report: inflammatory spinal-cord disease

A 2019 report described a 67-year-old woman with frequent yawning and seven days of progressive neurological symptoms. She had impaired coordination and reduced sensation on the left side. MRI showed inflammation extending through several cervical spinal-cord segments into the lower medulla, and aquaporin-4 antibodies supported a diagnosis of neuromyelitis optica spectrum disorder. (7)

Her neurological symptoms improved and yawning normalized during treatment directed at the inflammatory disease. The case is useful because yawning appeared alongside objective neurological abnormalities. It was not a case of ligament-related cervical instability and does not support treating similar symptoms with cervical injections.

“Cervical” in this report refers to the location of spinal-cord inflammation. It should not be confused with excessive motion of the neck joints. Likewise, her one-sided neurological syndrome did not mean that half of her body had become enlarged or atrophied.

New 2025 research: yawning around epileptic seizures

A retrospective video-EEG study examined 236 patients with temporal lobe epilepsy. Twenty-six patients had yawning around recorded seizures, and 36 of 1,018 seizures included yawning. The researchers examined whether this could help characterize seizure onset in an already selected epilepsy population. (8)

These findings do not mean that ordinary yawning indicates epilepsy. They show why repeated stereotyped episodes accompanied by staring, loss of awareness, unusual movements, or confusion need a different interpretation from yawning during an ordinary tired afternoon.

Does yawning cool the brain?

Brain cooling is one of the main ideas discussed in the video and existing article. The proposal is that yawning-related movements, breathing, and circulatory changes could help exchange heat and contribute to temperature regulation. Comparative and physiological research has been interpreted as supporting this thermoregulatory hypothesis. (9)

The brain produces heat through metabolism, and blood flow participates in heat exchange. Temperature relationships vary with activity, location, environmental conditions, and measurement technique. It is too simple to say that every yawn pushes a fixed quantity of hot venous blood out and replaces it with cooler arterial blood.

Why brain-temperature research matters

A 2023 review discusses brain temperature in healthy and diseased states and the use of magnetic resonance spectroscopy to study it. Temperature can be relevant to neurological function and disease, but that review does not validate excessive yawning as a thermometer or establish a cervical cause of abnormal temperature. (10)

The useful distinction is between a plausible physiological role and a diagnostic claim. A person can feel hot, mentally slowed, or fatigued without proof that the brain is overheating. Conversely, not feeling hot does not exclude a medical cause of cognitive symptoms.

Excessive yawning and intracranial hypertension

Intracranial hypertension means abnormally raised pressure inside the skull. Causes and clinical settings differ. Idiopathic intracranial hypertension is a specific diagnosis made after appropriate investigation excludes other explanations; it is not another name for all head-pressure sensations.

Symptoms that can occur with raised intracranial pressure include headache, transient visual obscurations, double vision, and pulsatile tinnitus. Evaluation may involve assessment for optic-disc swelling, appropriate brain and venous imaging, and lumbar-puncture opening pressure when indicated and safe. The pressure measurement must be interpreted with the other findings. (11)

Excessive yawning alone does not establish this diagnosis or mean that a person needs a lumbar puncture. It also does not establish brain herniation. The severe neurological conditions mentioned in the transcript should not be presented as the expected explanation for an isolated symptom.

Our article on cervical instability, fluid pathways, and intracranial hypertension discusses our structural perspective alongside the broader issue of pressure regulation.

Our proposed cervical connection: jugular drainage and brain physiology

Some patients tell us that frequent yawning began with neck pain, dizziness, headaches, head pressure, or brain fog. Our question is whether a cervical problem could contribute to the broader symptom pattern in selected circumstances.

The internal jugular veins are important venous drainage routes near the cervical spine. Our published 2024 hypothesis discusses how altered cervical structure and ligamentous instability might influence nearby vascular pathways and fluid movement. It combines anatomy, literature, and observations from a selected clinical population. It is not a controlled study demonstrating that jugular compression causes excessive yawning. (12)

We ask then whether impaired venous outflow could alter heat exchange and provoke yawning. This remains a proposed mechanism.

Normal venous drainage changes with posture

Brain drainage does not depend on the jugular veins alone. A 2024 review describes interactions among the craniospinal venous system, posture, and cerebrospinal-fluid pressure. Upright posture shifts some venous drainage toward vertebral venous pathways. A smaller-looking jugular vein in one position is not automatically a disease finding. (13)

A clinically important outflow problem therefore requires interpretation beyond a narrow image. Arterial blood supply, venous drainage, and cerebrospinal-fluid movement are related but distinct processes. The transcript’s figure about venous volume should not be read as saying that most of everything inside the skull consists of venous fluid.

Our internal jugular vein stenosis article develops this discussion.

Brain fog does not prove toxin accumulation or neuron loss

The video discusses trapped metabolites, changes in personality, and brain atrophy. These are proposed links within Dr. Hauser’s explanation, not conclusions established by the presence of yawning or brain fog.

Cognitive complaints can reflect sleep disruption, migraine, medication effects, mood disorders, postinfectious illness, endocrine problems, neurological disease, and other contributors. Brain atrophy is an imaging finding with a differential diagnosis. It cannot be inferred from frequent yawning, neck clicking, or difficulty concentrating, and these symptoms do not establish Alzheimer’s disease.

“Brain fatigue” and physical fatigue can overlap

In the video we make a practical observation: some people describe depleted physical energy while others emphasize difficulty processing information, concentrating, or tolerating computer work. Preserving the person’s description can help explain how symptoms affect everyday life.

These are not validated categories that distinguish intracranial hypertension from hormonal disease or other medical problems. Physical fatigue and cognitive fatigue can coexist. Body temperature, feeling cold, or worsening at a computer cannot reliably identify whether the source lies in the brain or elsewhere.

Computer-related worsening can also involve visual demands, sustained posture, migraine sensitivity, sleepiness, or cognitive exertion. It should not automatically be interpreted as evidence of jugular obstruction.

Yawning and ear pressure

Yawning moves muscles that can help open the Eustachian tubes, which connect the middle ear with the back of the nose. This can help equalize middle-ear pressure. It is a different process from changing pressure within the skull.

The video describes a patient who felt as though the ears were “sucking in” during yawning and sometimes ordinary breathing. That is a useful symptom description. It does not identify the cause without an ear-related assessment, and the transcript does not provide the measurements needed to establish Eustachian-tube dysfunction, intracranial hypertension, or a cervical mechanism.

Ear fullness, changes in hearing, dizziness, and pressure sensations can overlap. New hearing loss or persistent ear symptoms deserve attention in their own right.

What testing can establish

The appropriate questions depend on the accompanying symptoms. Sleep history and medication review may be particularly relevant when yawning accompanies daytime sleepiness. New neurological findings may instead call for neurological investigation. Not everyone needs the same testing.

In the video, Dr. Hauser describes extracranial and transcranial Doppler studies in discussing blood-flow patterns. Doppler measures aspects of flow velocity and related waveforms; it does not directly measure brain temperature, neuronal death, or the amount of accumulated toxins.

Optic-nerve-sheath ultrasound is another indirect measurement sometimes discussed in relation to pressure. A 2025 systematic review found that the relationship between changes in sheath size and intracranial pressure varies between individuals. It should not be treated as one universally convertible pressure reading. (14)

Neck clicking, popping, grinding, or muscle tension may make musculoskeletal symptoms relevant to the history. They do not, on their own, diagnose ligament injury or explain excessive yawning.

Where cervical treatment evidence fits

The presentation describes cervical curve work and Prolotherapy within our proposed structural model. These source descriptions should not be converted into a treatment recommendation for everyone who yawns excessively.

Our review of cervical capsular-ligament laxity discusses instability, chronic neck pain, and the rationale for Prolotherapy. It is not a controlled yawning study. (15)

A small six-patient cervical Prolotherapy case series reported pain and radiographic findings, but did not establish treatment of excessive yawning, elevated brain temperature, or intracranial hypertension. (16)

A proposed repair response in ligament tissue, improvement in neck pain, and resolution of a neurological symptom are separate outcomes. Cervical injections also carry risks, including bleeding, infection, and nerve or vascular injury. Treatment claims should match the diagnosed condition and the evidence available.

A patient describes 15 years of unusual yawning after a collision

The interview “Nonstop yawning, drop attacks, & post-whiplash syndrome from ligamentous injury in the neck” adds a detailed patient perspective to this discussion. The patient describes a rear-end motor-vehicle collision in October 2007, while his head was turned. He recalls little immediate pain, but an unusual neck sensation followed by marked symptoms the next morning.

The yawns changed in duration, frequency, and associated symptoms

He reports that his yawns became two to three times longer than before and were accompanied by painful throat contractions. He estimates that some bouts involved hundreds of yawns and continued for hours. Those numbers are his recollection, rather than a recorded yawn count, but they communicate how disruptive the episodes felt.

He also describes tears coming from the right eye during individual yawns, alongside right-sided facial numbness, tingling, burning pain, and hand symptoms. This is a more specific account than simply feeling tired and yawning more often. Duration, clustering, pain, and associated neurological symptoms all contribute to the clinical picture.

The interview does not establish that his throat muscles were tearing, even though that is how he describes the sensation. Similarly, one-sided tearing does not independently diagnose vagal injury, impaired brain drainage, or a particular cranial-nerve disorder.

A broader illness affected work, balance, and reading

The patient reports reduced hand strength, difficulty opening a drink bottle, persistent neck and shoulder muscle spasms, and a longstanding head tilt. He says he had been unable to work for approximately two and a half years before the interview.

He also describes sudden falls or episodes of finding himself on the ground, which the conversation calls “drop attacks.” That phrase describes an event rather than identifying its cause. The transcript does not establish whether these episodes involved syncope, a vestibular problem, seizures, a vascular disorder, or another mechanism.

Cognitive changes were particularly distressing. He contrasts previously reading long books readily with later difficulty completing even a short children’s book. He reports poorer short-term memory, slower thinking, and diminished ability to plan. These details illustrate functional loss without establishing elevated brain pressure or neuron damage.

Other reported symptoms included heartburn, episodes of a racing heartbeat, and darkening vision with physical activity. The transcript does not include ECG recordings, blood-pressure records, or testing that verifies the explanation for these episodes.

Changes after manual treatment and Prolotherapy

He recalls a change in facial and hand symptoms after upper cervical manual treatment, followed by a period of pronounced tearing from one eye. He then describes a return of a normal-feeling yawn after moving his neck and hearing a pop. These events are his recollection of the sequence; they do not establish which structure changed or why.

His account should not be used as an instruction to twist or forcefully crack the neck. Nor does improvement after a maneuver prove that a vertebra had been displaced or that intracranial pressure fell.

He subsequently describes Prolotherapy and continued chiropractic care. He says the first Prolotherapy visit was physically difficult and that improvement was much clearer after the second. Later, he reports being able to hold his head more upright, less throat spasm and yawning, better hand function, and improved reading, memory, and energy. He also says he had not experienced another dizzy spell or drop attack since his first Prolotherapy appointment.

These are reported outcomes during care involving more than one intervention. His sense that the neck was more stable, and the chiropractor’s reported impression, are not substitutes for standardized measurements of ligament healing. The interview cannot separate treatment effects from other influences or establish an expected number of treatments.

Improvement did not mean every limitation had disappeared

The patient still described restricting activity and avoiding a position that could provoke neck discomfort, facial symptoms, or throat spasm. Those remaining limitations belong in the story alongside the improvements.

His account illustrates how meaningful a return of ordinary abilities can be after prolonged illness. It does not document a complete recovery, provide a cure rate, or independently establish the diagnosis of intracranial hypertension. The opening statement connecting chronic yawning with high brain pressure is a proposed interpretation in this interview; yawning alone is insufficient to make that diagnosis.

How the patient account fits with the research

Published research supports considering neurological and other medical explanations when yawning is unusual and accompanied by concerning symptoms. (6) Our cervical hypothesis raises a separate question about possible structural contributions in selected patients. (12)

This interview adds an individual experience, not a controlled test of that hypothesis. The transcript supplies no direct intracranial-pressure measurement, brain-temperature measurement, or simultaneous venous-flow assessment demonstrating the proposed mechanism.

The other existing interview, “Mini-strokes, brain fog, headaches—Jovana’s cervical instability and Prolotherapy story,” should remain a separate patient account. An interview title does not independently verify a vascular diagnosis, and the two stories should not be combined into one clinical history.

When excessive yawning needs prompt attention

Sudden yawning accompanied by facial droop, weakness, speech difficulty, new loss of vision, severe imbalance, or a severe unusual headache requires emergency assessment because of the accompanying neurological symptoms.

New confusion, reduced consciousness, seizure-like episodes, or rapidly worsening symptoms also needs urgent attention. Persistent excessive yawning without those features can still warrant medical evaluation, particularly if it interferes with daily life or accompanies pronounced sleepiness, recurrent fainting, or new visual changes.

The purpose of evaluation is to explain the symptom pattern. Excessive yawning should neither be dismissed automatically as boredom nor treated automatically as evidence of a dangerous pressure disorder.

Understanding the whole pattern

Yawning is a normal behavior that can become clinically relevant when its pattern changes. The useful questions are what changed, what accompanies it, and what evidence supports a particular explanation.

We remain interested in possible cervical contributions in selected patients, especially when yawning occurs within a broader neck-related illness. That interest can coexist with careful attention to sleep, medications, migraine, autonomic symptoms, and neurological disease. The symptom deserves an explanation that goes beyond the yawn itself.

Medical disclaimer: This article provides general education and does not replace individual medical assessment. Patient experiences do not predict another person’s outcome. Do not stop or change prescribed medication based on this article or video.

Meet patients who recovered from excessive yawning and many other symptoms associated with ligamentous cervical instability:

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