Q:

11/11/2012
I have seen many patients who are saying after a big yawn they are getting acute asthma attacks. I told them to take a deep breath after yawning but some are saying it’s not working. They all are taking Transhalers (Budamate 200 2 doses twice a day)

A:

Thank you for your inquiry.

I am unaware of any documentation that yawning itself can produce asthma. However, it is clear that yawning and deep breathing can be associated with stress and anxiety, and such can be interpreted by the patient as dyspnea. In an asthmatic who interprets the need for yawning or sighing respirations with deep breaths as dyspnea, the dyspnea is oftentimes attributed to asthma.

I can only hypothesize in your patients the yawn and the deep breaths (probably sighing respirations) are related to stress, and that they are interpreting the sensation of dyspnea that goes along with these disorders of breathing as being due to their asthma. The abstracts and the website link copied below are sources of discussions of this phenomenon.

Thank you again for your inquiry and we hope this response is helpful to you.

Chest. 2006 Dec;130(6):1723-5. Disproportionate breathlessness associated with deep sighing breathing in a patient presenting with difficult-to-treat asthma. Prys-Picard CO, Kellett F, Niven RM.
Source
North West Lung Research Centre, Wythenshawe Hospital, Southmoor Road, Manchester OL5 0BA, UK.
Abstract
Disproportionate breathlessness is a term that is used synonymously with dysfunctional breathing and idiopathic hyperventilation in the absence of chest disease. In the presence of chest disease, it may not be possible to use these three terms interchangeably. We report a case of a patient with documented asthma but breathlessness that was out of proportion to the measured lung function or exercise tolerance. The breathing pattern was abnormal and was characterized by the need to take frequent deep sighs, which increased in frequency during incremental exercise, despite increasing respiratory rate and tidal volume. Treatment with physiotherapist-led breathing retraining resulted in an improvement in the sigh rate and breathlessness scores. Disproportionate breathlessness and deep sighing breathing are part of the spectrum of conditions that comprise dysfunctional breathing and can cause symptoms that may be wrongly attributed to asthma.

Thorax. 2002 Oct;57 Suppl 2:II31-II35. Dysfunctional breathing in asthma: is it common, identifiable and correctable? Morgan MD.
Source
Institute for Lung Health, Department of Respiratory Medicine and Thoracic Surgery, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.

Yawning - The Easiest Remedy Against Stress

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology