Excessive Daytime Sleepiness

Excessive daytime sleepiness is a common problem among children and teenagers. Excessive daytime sleepiness in children is poorly recognized and underreported by parents leading to a delayed diagnosis.

What are the causes of excessive daytime sleepiness in children?
It is caused by a wide range of sleep disorders and other conditions. Excessive daytime sleepiness can be due to :

1. Insufficient sleep duration which might be because of unhealthy sleep habits, insomnia due to sleep associations/limit setting and anxiety
2. Fragmented/disturbed sleep due to obstructive sleep apnea (OSA) or restless legs syndrome (RLS).
3. Circadian misalignment due to Delayed Sleep Wake Syndrome
4. Primary disorders that increase sleep needs like Narcolepsy, Kleine-Levin syndrome etc.

What are the problems associated with excessive daytime sleepiness in children?
Untreated pediatric sleep problems and associated daytime sleepiness leads to imapired health, behavioral problems, mood disturbances, depression, impairments in neurocognitive function and poor school performance. Sometimes, children with daytime sleepiness report to doctors when parents become concerned about behavioral, mood, and academic issues and they may not attribute this to the underlying sleep problems. Young children might develop symptoms such as hyperactivity and oppositional behavior as they are unable to verbalize the internal state of “sleepiness.”

How do we diagnose the cause of excessive daytime sleepiness in children?
The diagnosis of excessive daytime sleepiness in children requires a detailed case history and examining the child by a sleep specialist. The child might require some investigations like an Actigraphy, Sleep Study or Polysomnography, Multiple Sleep latency test (MSLT) and Maintenance of Wakefulness Test (MWT).