Approach to a sleepy child: Diagnosis and treatment of excessive daytime sleepiness in children and adolescents

Purpose: The aim of this review is to give updated information to pediatric neurologists on the correct diagnostic approach and treatment of excessive daytime sleepiness (EDS) in children and adolescents. Due to the change in the society habits, EDS is becoming an emerging problem for the health system. At the present there are few articles specifically devoted to the evaluation of EDS. EDS is often reported in several manuscripts as a side effect of other sleep disorders (obstructive sleep apnea, circadian disorders, etc.) or of the use of drugs or of the substance abuse or as a consequence of bad sleep habits and poor sleep hygiene. EDS, especially in children, may manifest with paradoxical symptoms like hyperactivity, inattention, and impulsiveness. However, common sign of EDS in children are the propensity to sleep longer than usual, the difficulty waking up in the morning, and falling asleep frequently during the day in monotonous situation. The diagnosis should include subjective (sleep diaries, questionnaires) and objective (polysomnography, multiple sleep latency test, etc.) instruments to avoid misdiagnosis.Narcolepsy is the most studied central disorder of hypersomnolence, and it is a predominantly pediatric disease with a peak age of onset in prepuberty but the diagnosis is often delayed especially in mild forms. The early and correct treatment of narcolepsy and of other form of EDS is extremely important since late and inappropriate treatments can affect the psychosocial development of the children and adolescents.

Automated summary

The purpose of this review is to provide updated information on the diagnosis and treatment of excessive daytime sleepiness (EDS) in children and adolescents to pediatric neurologists. EDS is an emerging problem for the health system due to changes in societal habits. The evaluation of EDS is often lacking in the current literature. EDS is commonly reported as a side effect of other sleep disorders or as a consequence of poor sleep habits. It can manifest with symptoms such as hyperactivity and inattention in children. The diagnosis should include subjective and objective measures to avoid misdiagnosis. Particularly, early and correct treatment is crucial for the psychosocial development of children and adolescents with narcolepsy and other forms of EDS.