What is the Epworth Sleepiness Scale?

Mary McMahon
Mary McMahon

The Epworth Sleepiness Scale (ESS) is an assessment test used to measure daytime sleepiness. People with high levels of daytime sleepiness may be experiencing sleep disorders such as insomnia and sleep apnea. The test can be used to evaluate people for sleep disorders and to follow up on a patient who has received treatment for a sleep disorder. It consists of a series of self-reporting questions that the patient answers.

Those who cannot remain awake at work will most likely score high on the Epworth sleepiness scale.
Those who cannot remain awake at work will most likely score high on the Epworth sleepiness scale.

On the test, the patient is asked to report on the likelihood of dozing or falling asleep in a series of situations. The responses are numbered between zero and three to indicate whether falling asleep is very unlikely or highly probable. The responses are tallied at the end for a single numerical score. Average scores for adults are around six, while scores of 10 or higher indicate that a patient has excessive daytime sleepiness.

Sometimes used to treat sleep apnea, nasal strips work by pulling open up the nostrils, making it easier to breathe through the nose.
Sometimes used to treat sleep apnea, nasal strips work by pulling open up the nostrils, making it easier to breathe through the nose.

Sample situations on the Epworth Sleepiness Scale include: watching television, sitting quietly after an alcohol-free lunch, sitting and reading, lying down to rest, and being the driver of a car that is temporarily stopped in traffic. The test was devised by Australian physician Dr. Murray Johns in the early 1990s as an evaluation tool for patients who appeared to be experiencing daytime sleepiness. It is used all over the world in a variety of clinical settings.

Those with sleep disorders may have high levels of daytime sleepiness.
Those with sleep disorders may have high levels of daytime sleepiness.

The advantage of using a test of this nature, rather than simply asking patients to report if they experience daytime sleepiness, is that it presents patients with common situations and requires concrete answers, increasing the chances that patients will report accurately. It also creates a score that can be compared with other patients and recorded in a patient's chart, allowing a doctor to track a patient's condition over time. The Epworth Sleepiness Scale is also useful for providing standardized care, including appropriate interventions for patients who experience daytime sleepiness.

A patient's score on the Epworth sleepiness scale may be diagnostically relevant, so it is often included in his medical chart.
A patient's score on the Epworth sleepiness scale may be diagnostically relevant, so it is often included in his medical chart.

Several websites host complete Epworth Sleepiness Scale questionnaires that people can use to self-assess if they are concerned about daytime sleepiness. It is important to be aware that an evaluation from a doctor can still be necessary even if a score is low. If a person has a high score on the Epworth Sleepiness Scale, it is a good idea to make an appointment to see a doctor about daytime sleepiness for further evaluation. The doctor can perform diagnostic tests to learn more about why the patient is experiencing sleepiness and provide patients with treatment options.

People with high levels of daytime sleepiness may be experiencing sleep disorders.
People with high levels of daytime sleepiness may be experiencing sleep disorders.
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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