Assessments of sleepiness in adolescents: A key tool for better intervene in mental health
Objectives Daytime sleepiness in adolescents has negative impacts on physical, cognitive, and emotional health, with direct or indirect consequences on their mental health. This review aims to describe specialized tools assessing daytime sleepiness in adolescents so that mental health professionals can screen for a variety of sleep disorders, from the rarest ones, such as narcolepsy, to the most common ones, such as sleep-wake cycle delay in adolescents. Method Articles were selected in Medline ( https://pubmed.ncbi.nlm.nih.gov/) and targeted adolescents aged between 13 and 18 or the keyword “adolescent*”. The keywords used were: “sleepiness test” AND “questionnaire*”. Only articles in French or English and published until January 9, 2023 were included. A total of 277 scientific articles were screened. Final sample included a total of 35 articles describing sleepiness measurement tools in adolescents. Results Among the 35 articles, a total of seven daytime sleepiness measurement tools in adolescents were identified. Four of them were subjective: 1) the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), 2) the Pediatric Daytime Sleepiness Scale (PDSS), 3) the Cleveland Adolescent Sleepiness Questionnaire (CASQ) and 4) the French Sleepiness Scale for Adolescents (FSSA). These self-reported questionnaires are less expensive and they can be used easily by mental health professionals as opposed to objective tools. Three objective tools have been identified: 1) the multiple sleep latency test (MSLT), 2) the maintenance of wakefulness test or called the “Maintenance Wakefulness Test” (MWT) and 3) the pupillographic sleepiness test (PST). Conclusion Given that adolescents end-of the-day sleep pressure, often resulting in a greater opportunity to light exposure, they are more at risk for daytime sleepiness and consequently to mental health challenges. Mental health professionals should therefore systematically screen for daytime sleepiness in adolescents using subjective tools. There are reliable and validated tools that are translated into French, such as the FSSA and the ESS-CHAD to measure daytime sleepiness in adolescents and lifestyles problems associated with sleep loss When daytime sleepiness suggests the presence of medical-based sleep disorders, such as narcolepsy, restless sleep disorders or sleep apnea, it is important to pursue an investigation with objective tools (nocturnal polysomnography, MLST and MWT) in collaboration with the adolescent’s physician.