Hypersomnolence in children and adolescents: Causes, assessment, and management

Hypersomnolence is common in children and adolescents and its etiology is multifactorial. Developmental changes in melatonin release and slower accumulation of sleep pressure lead to a preference for later sleep times, which conflicts with early school start times leading to increased daytime sleepiness. Although the most common cause of daytime sleepiness in children and adolescents is insufficient sleep, central disorders of hypersomnolence can also manifest in these age groups. Excessive sleepiness could also result from other disorders such as sleep ap- nea, psychiatric illnesses, and medication use. Hypersomnolence should be evaluated by careful history taking, and when necessary additional tests including actigraphy, polysomnogra-phy, and multiple sleep latency test may need to be performed. In this review, we discuss the prevalence of hypersomnolence in children and adolescents, common etiological factors, and assessment of excessive sleepiness. We also discuss management strategies for hypersomnolence.