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MINI-REVIEW

Do face masks prevent yawning? A key factor to consider in sleep research

Reza Rastmanesh1,2*
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1 Kave Physicians Building, Tehran, Iran
2 The Nutrition Society, London, United Kingdom
Global Translational Medicine, 025480088 https://doi.org/10.36922/GTM025480088
Received: 24 November 2025 | Revised: 12 February 2026 | Accepted: 12 February 2026 | Published online: 5 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The COVID-19 pandemic has resulted in widespread face mask usage to curb disease spread. However, an unintended effect is that masks may contribute to sleep disturbances. Since sleep and excessive sleepiness are closely connected to yawning, the typical design of face masks might restrict jaw movement, thereby altering normal yawning behavior. Moreover, masks can interfere with contagious yawning by making it harder to recognize yawns in social and community environments. Yawning influences alertness and facilitates transitions between wakefulness and sleep—particularly through thermoregulation—wearing face masks, theoretically restricts jaw movement. Factually, face masks also impede the occurrence of contagious yawning by obstructing the visual detection of yawns. While altering airflow dynamics, face masks may disrupt the counter-current heat exchange with the external environment, a process integral to yawning. Face masks can potentially introduce clinical uncertainties and subtle statistical biases in epidemiological studies and clinical trials. In this review, these theoretic and factual points are used to support the hypothetical mechanism proposed. This paper explores the possible sources and hypothetical mechanisms of such bias. The proposed hypothesis carries potential implications for ongoing clinical trials, the interpretation of retrospective and prospective data across different contexts, the reassessment of sleep disorder diagnostic criteria, standards for systematic reviews, meta-analyses comparing data from before and after COVID-19, and, crucially, the reevaluation of previous findings and comparative research. This paper provides a conceptual discussion identifying possible sources of bias, rather than a systematic or quantitative analysis.

Keywords
Face mask
Sleep research
Yawning
Jaw motion
Temporomandibular movement
Funding
None.
Conflict of interest
The author declares no conflicts of interest.
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