If you find yourself falling asleep during the day, you might question whether you are too sleepy. There is a simple screening tool used by sleep doctors to identify individuals who suffer from excessive daytime sleepiness. Learn the questions that are part of it and how they may help to identify problems associated with sleep disorders, like sleep apnea and narcolepsy.

THE EPWORTH SLEEPINESS SCALE. To check your sleepiness score, total the points. Check your total score to see how sleepy you are. THE EPWORTH SLEEPINESS SCALE How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most.

Before we can measure sleepiness, by any method, we need some understanding of what it is that we want to measure. Unfortunately, this has not received the attention it deserves, and many people remain confused about the nature of sleepiness. This is a scale that aims to evaluate daytime sleepiness and is used mainly in diagnosing sleep disorders. As the name states, it has been introduced in 1991 in the Epworth Hospital in Melbourne by Dr Murray Johns. The Epworth Sleepiness Scale calculator comprises of 8 multiple choice questions, each with the same scale of 4 answers. The Epworth Sleepiness Scale is one of the most prominent. It is considered a standard method of assessment used in the world of sleep medicine. The Epworth Sleepiness Scale (ESS) is a test for adults developed in 1990 with some modifications to this test being implemented in 1997. Use the following scale to choose the most appropriate number for each situation: 0 = would never doze 1 = slight chance of dozing 2 = moderate chance of dozing 3 = high chance of dozing It is important that you answer each question as best you can. Situation Chance of Dozing (0-3) Sitting and reading Watching TV. Mexican Version of the Epworth Sleepiness Scale The Open Sleep Journal, 2009, Volume 2 7 18–70 years) in accordance to the following inclusion crite- ria: regular schedule for work or school activities (morn- ing/afternoon, but not night shift); subjective nocturnal sleep time at night from 6–9 h, and subjective sleep latency.

The Epworth Sleepiness Scale

The Epworth sleepiness scale is a questionnaire that is routinely used to assess the degree of an individual’s sleepiness. It is a subjective measure completed by patients. However, it can be helpful in quantifying one's sleepiness over time.

The scale is completed by an individual and given to his or her doctor. It is often used as a screening test for sleepiness or to monitor response to treatment.

Assessment

The scale measures an individual’s likelihood of falling asleep in routine life situations. Often, there is a prompt like, 'How likely are you to doze in the following activities?' This assessment reflects the recent past while observing your usual routines.

Other situations described in the questionnaire include:

  • Sitting and reading
  • Watching television
  • Sitting inactively in a public place
  • Riding as a passenger in a car for one hour without a break
  • Lying down to rest in the afternoon when circumstances permit
  • Sitting and talking with someone
  • Sitting quietly after lunch without alcohol
  • Sitting in a car as the driver while stopped for a few minutes in traffic

Calculating Your Score

Pdf

For each situation, a score is assigned that indicates the likelihood a person would fall asleep. The scores range from zero to three:

  • 0 = would never doze
  • 1 = slight chance of dozing
  • 2 = moderate chance of dozing
  • 3 = high chance of dozing

The total score can range from zero to 24. Higher scores are correlated with increased sleepiness.

This correlation and validity have been established with a large study comparing the results of the Epworth scale to the ability to fall asleep during a Multiple Sleep Latency Test (MSLT).

What Does Your Score Actually Mean?

The average score among healthy adults is six. In general, scores higher than eight indicate excessive sleepiness. Most sleep physicians use 10 and higher as indicating someone is too sleepy.

Much higher scores may occur in patients with narcolepsy. The numbers may also be elevated in untreated idiopathic hypersomnia or, most commonly, in sleep apnea.

Though the Epworth sleepiness scale is easy to administer and adds some basic information about sleepiness, it is admittedly a measure with a somewhat limited purpose. As it depends on your subjective experience, it may not fully reflect your actual degree of impairment.

For example, when people have insomnia, their scores are usually lower. Thus, high scores alone are not sufficient to diagnose sleep apnea.

A Word From Verywell

If you are concerned about the quality of your sleep or your degree of daytime sleepiness, start by speaking with a sleep specialist. After reviewing your symptoms, appropriate testing can be arranged to help select the best treatment to help you feel better rested and alert throughout the day, no matter your activities.

  • Johns, M. 'A New Method of Measuring Daytime Sleepiness: The Epworth Sleepiness Scale.' Sleep;14:540.
  • Punjabi, N et al. 'Predictors of Objective Sleep Tendency in the General Population.' Sleep; 25:678.

The Epworth sleepiness scale (ESS) is a self-administered questionnaire that’s routinely used by doctors to assess daytime sleepiness. The person filling in the questionnaire rates how likely they are to doze off during the day in different situations.

The ESS was developed in 1990 by Australian doctor Murray Johns and named after the Epworth Sleep Center he established in 1988.

The questionnaire was created for adults, but it’s been used successfully in various studies of adolescents. A modified version — the ESS-CHAD — was created for children and adolescents. This version is similar to the adult ESS, but the instructions and activities have been changed slightly to make it more relatable to children and adolescents and easier to understand.

Daytime sleepiness may be a sign of a sleep disorder or underlying medical condition. The questionnaire may be used to help your doctor diagnose a sleep disorder or to monitor your response to treatment.

The ESS consists of eight questions. You’re asked to rate your usual chances of having dozed off or fallen asleep while engaged in different activities on a scale of 0 to 3. The activities included in the questionnaire are:

  • sitting and reading
  • watching TV
  • sitting inactive in a public place, such as a meeting or theatre
  • riding as a passenger in a car for an hour without a break
  • lying down to rest in the afternoon when circumstances permit
  • sitting and talking to someone
  • sitting quietly after a lunch without alcohol
  • sitting in a car, stopped for a few minutes in traffic

These activities vary in their somnificity, which is a term introduced by the creator of the ESS. It describes how different postures and activities impact your readiness to fall asleep.

Your scores provide estimates of how likely you are to fall asleep during routine situations in your daily life. The higher your score, the higher your daytime sleepiness.

You can download the ESS questionnaire from the America Sleep Apnea Association or through Division of Sleep at Harvard Medical School.

Each of the activities listed has an assigned score from 0 to 3 that indicates how likely a person is to fall asleep during the activity:

  • 0 = would never doze
  • 1 = slight chance of dozing
  • 2 = moderate chance of dozing
  • 3 = high chance of dozing

Your total score can range from 0 to 24. A higher score is associated with increased sleepiness.

Berlin Questionnaire

The following shows how your score is interpreted:

Epworth Sleepiness Scale Questionnaire

  • 0 to 10 = normal range of sleepiness in healthy adults
  • 11 to 14 = mild sleepiness
  • 15 to 17 = moderate sleepiness
  • 18 to 24 = severe sleepiness

A score of 11 or higher represents excessive daytime sleepiness which could be a sign of a sleep disorder or medical condition. If you score 11 or higher, your doctor may recommend you see a sleep specialist.

The following are some conditions that can cause excessive daytime sleepiness.

  • hypersomnia, which is excessive daytime sleepiness even after a long night of sleep
  • sleep apnea, in which you stop breathing involuntarily for brief periods during sleep
  • narcolepsy, a neurological disorder that causes sleep attacks in which a person can fall into and wake from REM sleep at any time of day during any activity

Excessive daytime sleepiness can also be caused by:

  • medical conditions, such as cancer and Parkinson’s disease
  • mental health conditions, such as depression
  • certain medications, including antihistamines, antidepressants, and adrenergic drugs
  • drug and alcohol use

The validity of the ESS has been established in multiple studies and in correlation with objective sleepiness tests, such as the multiple sleep latency test (MSLT). While it’s been shown to be a reliable way to measure daytime sleepiness, there’s evidence that it may not be a reliable predictor of sleep disorders, such as sleep apnea and narcolepsy.

The test has proven to be an effective screening tool, but isn’t meant to be used as a diagnostic tool by itself. This is because it can’t distinguish which sleep disorders or factors cause a person’s sleep propensity. The questionnaire is also self-administered, so scores are based on subjective reports.

A 2013 study looked at whether or not having the questionnaire administered by a physician instead of self-administering was more accurate in people with suspected obstructive sleep apnea.

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The results showed the physician-administered scores to be more accurate. This suggests that having a doctor administer the questionnaire may make the ESS more reliable in predicting sleep apnea.

The ESS is not a diagnostic tool and can’t diagnose a sleep disorder. The questionnaire is meant to be used as a screening tool to help your doctor determine whether or not you need further testing, such as a referral for a sleep study.

Mood Disorder Scale Pdf

There are other factors that can influence your results and cause your score to be higher, such as occasional insomnia.

Epworth Sleepiness Scale Score Meaning

If you’re worried about the quality of your sleep or concerned that you may have a sleep disorder, see your doctor regardless of what your self-assessment reveals.