cas 45 :"On
Call: I'm a 62-year-old man in good health. I
take Zocor for my cholesterol as well as a
baby aspirin and several vitamins every day.
My problem may seem silly, but it's really a
nuisance: uncontrollable yawning. Do you have
any idea why I yawn so much or what I can do
about it?" Harv Mens Health Watch (2002).
6(9): 8.
cas 47 : A 46
year old man with obsessivecompulsive
disorder was referred by his psychiatrist
because of frequent yawning spells. It soon
became apparent that his movements,
superficially resembling yawning, were
different from his normal yawning.
The
yawning movements
were preceded by a sensation of drowning or
suffocation that could only be relieved if
the yawning movement was "just right: I need
that good breath". The yawning was
temporarily suppressible, and did not occur
if the patient was distracted. The yawning
could be substituted for by a sigh, which
also abolished the sensation of asphyxia.
Diazepam helped to reduce the movement. There
was history of previous tics, and the family
history was notable for Parkinson's disease.
As a child, the patient had obsessive rituals
that did not impair him. (extrait
de
Chouinard
S, Ford B Adult
onset tic disorders J Neurol Neurosurg
Psychiatry 2000; 68; 738-743)
cas 48 : A
23-year-old woman presented with 10 days of
progressive numbness of the face and arms,
diplopia, oscillopsia, and dysphagia.
She
reported an inability to sneeze or
yawn and
meals were followed by 5 minutes of
hiccups. She had a history of venous
thrombosis and a family history of
systemic lupus erythematosus
(SLE).
Cas 50 :
CPAP and Yawning
Basic fact, yawning is
an indication that you are tired.
So, why yawning now?
Because of the constant awakenings as a
result of sleep apnea, we become tired, then
fatigued, then more fatigued, then a zombie
..... It seems somewhere along the line some
of us at least go beyond the normal reaction
to lack of sleep and fail to exhibit the
normal reactions. One of the many things I
quit experiencing with sleep apnea was an
occasional yawn.
When we start NPAP
therapy, we first catch up on severly
delenquent REM sleep (experiencing what is
called REM rebound). We then get back into a
normal sleep mode with normal
sleep architecture and
normal circadian rhythums. If we get more
than the normal for adults 8+ hours per day
of sleep, we begin to pay back our sleep
debts.
During this period of
time we start to experience minor little
changes in our lives. Simple things like not
falling asleep behind the wheel. Seeing the
end of movies. Making it through the kids (or
grand kids) school program. Or yawning. My
co-workers thought I was nuts! It's not a
disbuted issue, but "yawning"! I began yawing
one afternoon at work. Several times. And
then I realized, I hadn't yawned in years! In
fact I couldn't remember when I had last
yawned. A lot of years!!!
And suddenly it dawned
on me that the yawning was a very simple,
very subtle sign that I was getting better. I
ran around telling everyone "Hey!, I'm
yawning!!!" Yes, a nut, but I was getting
better!!!
Now, a note of
caution. I went through a period of time when
I yawned, but as I continued to pay back my
sleep debt, I quit yawning again. After that,
if I pushed things, and got tired, I would
yawn. If I maintained proper sleep hygiene, I
don't yawn.
So, let yawning be a
sign. If you are still yawning after a year
like "Rested", it may be that you aren't
getting enough sleep to pay back your sleep
debt. Or perhaps that there is another
problem. If you occasionally yawn, get some
extra sleep for a night or two. Be aware of
your body, and your sleep it is
important.
Cas 59: Sometimes when I yawn or
stretch my arms out, my neck seizes up
(shooting pain to my head) and my eyes feel
like they are rolling around. This lasts for
around five to seven seconds. When I rub the
side of my neck, it all goes back to normal.
My doctor tells me to avoid yawning or
stretching but sometimes I do it without
thinking. At times I think I might faint.
(Male, 75).
Response : you suffer probably from
cervical osteoarthritis. The neck lordosis
during stretching (neck pain) may compress
the vertebral arteries and thus cause a
brainstem's ischemia (Vertebrobasilar
Insufficiency.) during which the functionnal
perturbation of cranial
nerve nucleus generate your optokinetic
nystagmus.
