Table 3.
Therapeutic strategies for excessive daytime sleepiness with insufficient sleep in adolescents.
| Causes | Therapeutic strategies | Approved interventions for adolescents | |
|---|---|---|---|
| Sleep deprivation and | Individual measures | • Bedtime determined by the parents | Yes |
| inadequate sleep hygiene | • Reduction of evening exposure to multimedia screens | ||
| • Management of somatic or psychiatric comorbidities | |||
| Family measures | • Family therapy if family issues | Yes | |
| Collective measures | • Classes at a later start time | Yes | |
| Individual or collective measures | • Sleep educational programs | Yes | |
| Insomnia disorders | First-line treatment | • Cognitive behavioural therapies for insomnia | Yes |
| Second-line treatment | • Pharmacological treatments if failure or contraindication to cognitive behavioural therapies for insomnia | No (off-label prescription) | |
| Complementary treatments | • Management of somatic or psychiatric comorbidities | Yes | |
| • Adequate sleep hygiene | |||
| Delayed sleep phase disorder | First-line treatment | • Morning bright light therapy combined to evening melatonin | No (off-label prescription for melatonin) |
| Alternative treatment | • Chronotherapy | Yes | |
| Complementary treatments | • Management of somatic or psychiatric comorbidities | Yes | |
| • Adequate sleep hygiene | |||
| Use of stimulant medications | • Adjustment of the dosage if necessary | Yes | |
| Misuse of stimulant medications/drugs | Individual measures | • Cognitive-behavioural therapy and/or motivational interviewing | Yes |
| • Management of psychiatric co-morbidities | |||
| Family measures | • Family therapy | Yes |