Yawning, Cravings And A Stiff Neck: What Migraine Prodrome Really Is

Before a migraine attack reaches the pain stage, your body often does something first. You might yawn over and over, without being tired. You might crave something salty or something sweet, for no clear reason. Your neck might feel stiff, the way it does after sleeping wrong, even if you didn’t. Then the headache arrives, and it’s easy to miss that these signs came first.

The phase before the pain has a name

This phase is called the migraine prodrome. It can start anywhere from a few hours to about two days before the headache begins, and it is a distinct part of the migraine attack itself [1]. In one of the earliest studies to track this phase closely, people with migraine used an electronic diary to record symptoms as they happened, before they knew whether a headache would follow. Yawning, food cravings, neck stiffness, tiredness, and difficulty concentrating were among the most commonly reported signs [1].

The prodrome is different from the headache phase that follows it, and different from aura, the temporary visual or sensory changes some people experience closer to the pain. Not everyone notices a prodrome, and that’s not a sign anything is wrong. It’s one of several ways a migraine attack can begin.

What’s happening in the brain during this phase

Researchers have used brain imaging to look at what happens during the prodrome, before any pain has started. In one study, researchers triggered migraine attacks in people with migraine and scanned their brains during the prodrome using PET, short for positron emission tomography, a technique that shows real-time activity in the brain. Activity increased in the hypothalamus, a small region at the base of the brain that helps regulate hunger, sleep, and other basic functions, during symptoms like yawning and food craving [2]. A separate study using the same imaging approach found similar hypothalamic activity during naturally occurring migraine attacks, not only triggered ones [3].

This shows the prodrome involves a measurable change in brain activity, beginning before the pain does. It’s also why food cravings during this phase are increasingly understood as a symptom the brain is already producing, rather than something a person eats that then causes the attack [2].

The neck stiffness question

Neck stiffness is one of the most commonly reported prodromal symptoms, but researchers are still working out exactly where it belongs. Some studies count it as part of the prodrome, alongside yawning and cravings. Others have found that neck pain often continues into the headache phase itself, which raises the question of whether it’s a true early sign or an early part of the attack that simply starts before the pain does [4]. Either way, neck stiffness that regularly shows up around your migraine attacks is worth mentioning to your healthcare professional, even if science hasn’t fully settled its exact place in the timeline.

It’s also one of the more frequently reported early signs among Migraine Buddy users specifically: 30% of users who track early signs report muscle stiffness, and 23% report tingling in the neck, before the pain starts.

What we don’t know yet

Not every study agrees on how common these symptoms are. A 2022 review pooling data from dozens of studies found wide differences in how often people reported a prodrome at all, from under a third of people in some population studies to about two-thirds of clinic patients. The individual symptom data was too inconsistent across studies to produce reliable numbers for yawning, cravings, or neck stiffness specifically [5]. The researchers concluded that better-designed studies are needed before the field can say with confidence how common any single prodromal symptom is, or how well it predicts an approaching attack.

In practice, this means your own pattern matters more than any general statistic. Some people notice a clear prodrome every time. Others rarely notice one at all. Both are normal.

Migraine Buddy’s own user data reflects this same variability. Among users who track early signs, 28% report yawning before the pain starts, but only 2% report food cravings, even though cravings tend to get more attention in conversations about prodrome. That doesn’t mean cravings aren’t real for the people who experience them, it just means they’re one of the less commonly logged early signs in practice.

Why noticing it might matter

Because the prodrome starts before the pain, some researchers have asked whether treating an attack during this phase, rather than waiting for the headache, changes the outcome. In a 2023 clinical trial, people who recognized their own prodrome symptoms and took a gepant, a type of acute migraine treatment, during that phase were less likely to develop moderate or severe headache within the next 24 hours, compared with placebo [6]. This trial looked at acute treatment taken during a specific attack, not preventive treatment taken daily, and its findings don’t apply to every migraine medication or every person. For some people, recognizing prodrome symptoms may be useful information to bring into a conversation with a healthcare professional.

The takeaway

Yawning, food cravings, and neck stiffness are not random. They’re three of the more common ways the migraine prodrome shows up, and they reflect real activity in the brain before the headache phase begins. The research is still catching up on the details: how common each symptom really is, how reliably it predicts an attack, and what to do with that information. What’s already clear is that these symptoms aren’t something to feel guilty about, and not something you’re imagining. If you notice a pattern in your own yawning, cravings, or neck stiffness before your migraine attacks, it’s worth bringing to your healthcare professional, and worth logging as it happens, before you have to rely on remembering it later.

References

1. Giffin NJ, Ruggiero L, Lipton RB, Silberstein SD, Tvedskov JF, Olesen J, Altman J, Goadsby PJ, Macrae A. Premonitory symptoms in migraine: an electronic diary study. Neurology. 2003;60(6):935-940.
2. Maniyar FH, Sprenger T, Monteith T, Schankin C, Goadsby PJ. Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks. Brain. 2014;137(Pt 1):232-241.
3. Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Hypothalamic activation in spontaneous migraine attacks. Headache. 2007;47(10):1418-1426.
4. Lampl C, Rudolph M, Deligianni CI, Mitsikostas DD. Neck pain in episodic migraine: premonitory symptom or part of the attack? Journal of Headache and Pain. 2015;16:80.
5. Eigenbrodt AK, Christensen RH, Ashina H, Iljazi A, Christensen CE, Steiner TJ, Lipton RB, Ashina M. Premonitory symptoms in migraine: a systematic review and meta-analysis of observational studies reporting prevalence or relative frequency. Journal of Headache and Pain. 2022;23:140.
6. Dodick DW, et al. Ubrogepant for the treatment of migraine attacks during the prodrome: a phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023;402(10419):2307-2316.