[Evaluation of excessive daytime sleepiness in child and adolescent psychopathology]

Childhood and adolescence are characterized by major changes in physiological, social and psychological domains. Some learning, behavior, mood or sleep disorders occurring during these ever-changing periods may lead children and teenagers to search for psychiatric care. It is then crucial to accurately determine which symptoms pertain to sleep and alertness disorders. Otherwise, some sleepy children and adolescents may be incorrectly considered as lazy, hyperactive or depressed. The evaluation of sleepiness requires a thorough physical examination (including the otorhinolaryngologic aspect), the completion of scales and brief questionnaires suited for pediatric patients, a fully completed sleep diary and in some cases biological or electrophysiological exams such as polysomnography (suited for the diagnosis of sleep apnea, narcolepsy, and periodic limb movement disorder). These investigations will help recognize excessive sleepiness, evaluate the often bi-directional links with the associated psychopathology and, should the case arise, diagnose primary sleep disorders (mostly sleep apnea in children and insufficient sleep in adolescents) and guide the adequate treatment.