What is an Epworth Sleepiness Score?

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  • Written By: C. Mitchell
  • Edited By: John Allen
  • Last Modified Date: 14 May 2020
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An Epworth sleepiness score is a numerical score from 0-24 that is measured on the Epworth sleepiness scale. The scale is a tool for measuring daytime sleepiness in adults, and consists of eight questions. Each answer is worth a value between 0 and 3, and the score is the composite total of all eight answers' values. The Epworth sleepiness score, if high, can act as an indication of sleep disorders, particularly sleep apnea. Neither the score nor the scale is designed to diagnose any particular disorder, but rather are meant as indicators of potential irregularities.

The Epworth sleepiness scale and corresponding Epworth sleepiness score were developed in the early 1990s by an Australian doctor studying sleep disorders at the Epworth hospital in Melbourne, Australia. As of 2010, the sleepiness scale was used as the preeminent screening tool for sleep disorders in adults in most countries of the world, and had been translated into 11 languages. The scale’s questionnaire is usually administered by a doctor or other medical professional, but copies are available from multiple sources online.

Participants in the sleepiness scale are asked to rate their likelihood of dozing off in eight different situations. All of the situations involve sitting during daytime hours, such as in front of the television or in the car. Answers are reported on a scale of 0-3, where 0 is “would never doze” and 3 is “high chance of dozing.” The Epworth sleepiness score is the total of all eight responses. Adults whose scores range from 0-9 are generally deemed “normal.” If the score is between 10 and 24, the test-taker is usually referred to a specialist for sleep disorder evaluation.

The scale’s questions are all framed in terms of likelihood, and do not ask participants to calculate the number of times they have actually dozed off in any given situation. The test is meant to measure a person’s sleepiness over time, and is not designed to calculate how tired or exhausted someone is at a given moment. Other tools, such as the Stanford sleepiness scale, provide results geared toward objective tiredness.

Scores on the Epworth scale are generally uniform between men and women, and do not vary with age. The average Epworth sleepiness score for normal adults in Europe, Australia, and the United States rests somewhere between 4.4 and 4.6. Test-takers are not usually recommended for further evaluation unless their scores top nine, however. If therapy is recommended, the sleepiness scale is administered again at set intervals during and after treatment to gauge improvement.

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Post 3

@donasmrs-- This is true. And this scale isn't only used in diagnosing a condition. I have sleep apnea and my doctor uses it routinely to see how I'm progressing and if the treatments are helping.

Post 2

@burcinc-- Have you ever received the test from a doctor?

The Epworth sleepiness scale is used to diagnose sleep disorders like sleep apnea or narcolepsy and it is effective. Of course, this is not the only thing that doctors look at. And other potential causes of the symptoms as you mentioned, will be checked for first, before considering sleep disorders.

The Epworth sleepiness scale is a validated test for the diagnosis of sleep disorders. So there is no doubt about its benefits and use.

Post 1

This sounds like a good test to determine how sleepy an individual is during the day. But I don't think it's a good idea to use it for diagnosing sleep apnea or other sleep disorders. There are so many different causes of fatigue and sleepiness. Thyroid disorder, diabetes and depression can all cause sleepiness. Some medications also cause it as a side effect. It's good to know if someone is sleepy, but I think that's as far as the Epworth sleepiness score will be beneficial.

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