Excessive yawning could be one of the earliest indicators that a migraine attack is beginning, according to neurologist Dr. Jessica Lowe, who shares medical insights on social media as Doctor Brain Barbie. In a recent TikTok video, Dr. Lowe explained that frequent yawning is not always a sign of tiredness but can be part of the prodrome phase, the earliest stage of a migraine attack that can occur hours or even days before the headache starts.
Understanding the Prodrome Phase
Migraines are a complex neurological disorder with multiple stages, typically marked by intensely painful, incapacitating, and recurrent headaches. The NHS warns that symptoms at the beginning of a migraine attack can include feeling very tired, yawning a lot, craving certain foods, feeling thirsty, changes in mood, a stiff neck, and increased urination. Dr. Lowe focused on yawning, linking it to the hypothalamus, a brain region that regulates sleep, wakefulness, appetite, body temperature, hormone release, and other automatic functions.
"Brain imaging studies have shown activation of the hypothalamus very early during migraine attacks before the pain phase begins," Dr. Lowe said. This is particularly relevant because many symptoms migraine patients experience during the prodrome phase—such as yawning, food cravings, fatigue, mood changes, difficulty concentrating, increased thirst, and neck discomfort—are functions that the hypothalamus helps regulate.
The Role of Dopamine
Dr. Lowe also highlighted the connection between yawning and dopamine, a neurotransmitter involved in reward, motivation, movement, and arousal. "When dopamine pathways are activated, yawning can occur—and we know that dopamine signalling appears to be altered in migraine," she explained. "In fact, migraine patients can be unusually sensitive to dopamine, which may help explain why symptoms like yawning, nausea, food cravings, and changes in alertness can occur before the headache phase."
She advised that if you notice yourself yawning repeatedly for no obvious reason, it does not automatically indicate exhaustion or a need for caffeine. Instead, for some migraine patients, it may be one of the first signs that a migraine attack has already begun. "Remember, a migraine attack doesn't necessarily start when the headache starts," Dr. Lowe emphasized. "The headache is just one phase of a neurologic process that may have been developing in the brain for hours or even days because migraine is a complex neurologic disorder with multiple stages—and the pain is only one part of the story."
Migraine Symptoms and Impact
Migraine pain is severe and predominantly affects one side of the head, intensifying with movement, and is frequently accompanied by nausea and vomiting. Many sufferers also experience acute sensitivity to light, sound, and smell. The NHS advises that recognizing early signs like excessive yawning can help individuals manage their condition more effectively, potentially allowing for early intervention to reduce the severity of an attack.
