Évaluer la somnolence diurne auprès des adolescents : un incontournable pour mieux intervenir en santé mentale

Touchette, Evelyne; Servot, Sabrina; Davidson-Urbain, William; Pennestri, Marie-Hélène; Godbout, Roger; Montplaisir, Jacques

doi:https://doi.org/10.7202/1106397ar

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Résumé

Objectifs La somnolence diurne des adolescents a des impacts négatifs sur la santé physique, cognitive et émotionnelle, engendrant des conséquences directes ou indirectes sur leur santé mentale. Cette recension vise à décrire les outils spécialisés pour évaluer la somnolence diurne chez les adolescents afin que les intervenants en santé mentale puissent dépister une variété de troubles de sommeil des plus rares comme la narcolepsie jusqu’aux troubles les plus fréquents comme le délai d’éveil-sommeil chez les adolescents.

Méthode Les articles sélectionnés devaient inclure des adolescents âgés de 13 à 18 ans ou le mot-clé « adolescent* ». Les mots-clés utilisés pour la recherche étaient les suivants : « sleepiness test » AND « questionnaire* ». Les articles devaient être écrits en français ou en anglais et publiés jusqu’au 9 janvier 2023. Un total de 277 articles scientifiques a été recensé. Au final, 35 articles ont été sélectionnés dans Medline (https://pubmed.ncbi.nlm.nih.gov/) rapportant des outils de mesure de somnolence auprès de la population adolescente.

Résultats. Parmi les 35 articles, un total de 7 outils a été répertorié comme évaluant la somnolence diurne. Quatre outils subjectifs ont été recensés : 1) l’Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) ; 2) le Pediatric Daytime Sleepiness Scale (PDSS) ; 3) le Cleveland Adolescent Sleepiness Questionnaire (CASQ) ; 4) French Sleepiness Scale for Adolescents (FSSA). Ces questionnaires autorapportés ont l’avantage d’être moins coûteux et sont utilisés par les intervenants en santé mentale contrairement aux outils objectifs. Trois outils objectifs ont été rapportés : 1) le test itératif de latence d’endormissement, Multiple Sleep Latency Test (MSLT) ; 2) le test de maintien de l’éveil, Maintenance Wakefulness Test (MWT) ; 3) le test de somnolence pupillographique (PST).

Conclusion Étant donné que les adolescents ont une plus grande tolérance à résister à la pression au sommeil de fin de journée, ce qui leur offre une plus grande opportunité d’exposition à la lumière, ils sont plus à risque de souffrir de somnolence diurne, ce qui risque d’interférer avec leur santé mentale. Les professionnels de santé mentale se doivent de dépister systématiquement la somnolence diurne chez les adolescents à l’aide d’outils subjectifs. Il existe des outils fiables, traduits et validés en français comme le FSSA et l’ESS-CHAD pour mesurer la somnolence diurne chez les adolescents et les mauvaises habitudes associées au manque de sommeil. Lorsque l’on suspecte la présence de troubles de sommeil d’origine médicale, comme la narcolepsie, les troubles du sommeil liés à l’agitation motrice ou l’apnée du sommeil, c’est alors que l’investigation de nature objective (polysomnographie nocturne, MLST et MWT) doit se poursuivre en collaboration avec le médecin de l’adolescent.

Mots-clés :

somnolence,
adolescents,
outils,
santé mentale

Abstract

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.

Keywords:

sleepiness,
adolescents,
tools,
mental health

Appendices

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