Which autonomic disturbance is a sign of NOWS?

Yawning is indeed a recognized sign of Neonatal Opioid Withdrawal Syndrome (NOWS). This condition occurs in newborns exposed to opioids during pregnancy and is characterized by a range of withdrawal symptoms that affect the autonomic nervous system. Yawning, in this context, is a manifestation of the body's attempts to regulate itself in the face of withdrawal from opioids. It can be associated with other symptoms like irritability, tremors, and gastrointestinal disturbances.

In contrast, other options do not align with the typical manifestations of autonomic disturbances seen in NOWS. For instance, decreased heart rate would indicate bradycardia, which is not typically associated with opioid withdrawal; rather, increased heart rate (tachycardia) is more common. Increased appetite generally does not occur as a symptom of withdrawal, since affected infants often display feeding difficulties or decreased appetite. Enhanced sensory perception, while potentially a feature in other contexts, is not a documented symptom of NOWS. Thus, yawning serves as a clearer indicator of the condition during the withdrawal process in neonates.