- Question
- I am a 55-year-old, obese man with Type 2
diabetes. I have also been treated for
hemochromatosis. My problem is what I describe
as violent yawning attacks. Anywhere from two to
five hours after meals, I yawn forcefully for
5-10 minutes. What could be causing these
yawning episodes, and what can I do to stop
them?
-
- Answer
- There are a number of possible causes for
your yawning episodes. As an older, obese man
with diabetes, the most likely explanation is
poor sleep due to sleep apnea, resulting in
daytime tiredness.
-
- Sleep apnea is a disorder in which breathing
stops for at least 10 seconds five or more times
an hour while a person is asleep, sometimes
happening hundreds of times a night. Research
has shown an association between sleep apnea and
Type 2 diabetes. Excessive yawning, which is
defined as a cluster of 10 to 30 yawns occurring
many times a day, can be the result of sleep
deprivation caused by episodes of apnea.
-
- One way to determine whether sleepiness may
be causing your yawning attacks is to evaluate
your level of tiredness using a tool known as
the Epworth
Sleepiness Scale.
-
- If your result is 10 or higher, you should
consult your doctor about having a
polysomnography, or sleep study, done in a sleep
lab to determine whether you do in fact have
sleep apnea. (During a polysomnography, a person
is wired up to various machines while he sleeps
to measure factors such as the level of oxygen
in his blood and the electrical activity in his
heart.)
-
- Another possibility to consider is that one
of your medicines may be causing your yawning
episodes. For instance, a class of
antidepressant drugs known as selective
serotonin reuptake inhibitors (SSRIs) is a
common cause of excessive yawning.
-
- Yawning caused by these drugs tends to stop
within a few days of reducing the dose or
stopping the medicine. A variety of other drugs
can also cause excessive yawning. If you suspect
that a medicine may be the culprit in your case,
be sure to speak with your doctor before making
any changes in your drug treatment.
-
- Since you have diabetes, it is also worth
noting that yawning may be a sign of
hypoglycemia, or low blood glucose. If this is
the cause, your yawning attacks will likely also
be accompanied by symptoms such as sweating,
trembling, dizziness, confusion, headache, and
irritability.
-
- Lastly, if the yawning occurs for only a
short period , it may indicate anxiety or
hyperventilation, a vasovagal reaction (in which
the involuntary nervous system causes the heart
to slow and blood pressure to drop). One of
various neurological disorders, such as
migraine,
epilepsy,
or a brain
tumor must be also investigated. If a
polysomnography indicates that you do not have
sleep apnea, it might be worth discussing a CT
scan or MRI of the head with your health-care
provider to rule out a neurological
condition.
-
- Olivier Walusinski, M.D., France
|
