Screen for Possible Narcolepsy in Two Steps

1Measure your patient's sleepiness

Epworth Sleepiness Scale1

Ask your patient how likely he or she is to doze or fall asleep in the following 8 situations, in contrast to feeling just tired. Ensure each question is answered or ask patients to estimate responses to unanswered questions based on recent times.

Rate your chance of dozing in each situation.

 Would Never DozeSlight Chance
of Dozing
Moderate Chance
of Dozing
High Chance
of Dozing
Sitting and reading
Watching television
Sitting inactive in a public place
(eg, a theater or a meeting)
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
In a car, while stopped for a few
minutes in traffic

Source: Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545. This copyrighted material is used with permission granted by the Associated Professional Sleep Societies, October 2012. Unauthorized copying, printing, or distribution of this material is strictly prohibited.

2Explore your patient's symptoms

Swiss Narcolepsy Scale2,3

This tool was created to screen individuals for narcolepsy with cataplexy. The SNS is not validated to screen for narcolepsy without cataplexy. Ask your patient to answer the questions by choosing the appropriate number.

Please answer the questions below by choosing the appropriate number. Share your scores with a sleep specialist.

(less than once a month)
(1-3 times a month)
(1-2 times a week)
How often are you unable to fall asleep?
How often do you feel bad or not
well rested in the morning?
 NeverI would like to,
but cannot
1-2 times
a week
3-5 times
a week
Almost daily
How often do you take a
nap during the day?
(less than once a month)
(1-3 times a month)
(1-2 times a week)
How often have you experienced weak
knees/buckling of the knees during
emotions like laughing, happiness, or anger?
How often have you experienced
sagging of the jaw during emotions
like laughing, happiness, or anger?

This copyrighted material is reproduced with permission of the authors. Unauthorized copying, printing, or distribution is strictly prohibited.

Optional Information:


Age Range:

These screening tools are not intended to make a narcolepsy diagnosis or replace complete evaluation by a sleep specialist.


Epworth Sleepiness Scale An ESS score >10 suggests excessive daytime sleepiness (EDS).1 Patients with EDS (ie, ESS >10) may need to be evaluated for a potential sleep disorder, including narcolepsy.4

Swiss Narcolepsy Scale An SNS calculated score <0 is suggestive of narcolepsy with cataplexy.2,3 All patients with an SNS calculated score <0 should be evaluated by a sleep specialist.4

Share these results with a sleep specialist.

The Epworth Sleepiness Scale and the Swiss Narcolepsy Scale can provide important information for a sleep specialist in screening for excessive daytime sleepiness and cataplexy in narcolepsy. Have your patient share these important scores with a sleep specialist and review the diagnostic sleep tests that help identify narcolepsy.

The Narcolepsy Conversation Starter is a useful tool for your patients when talking about narcolepsy. Download the PDF and share it with your patients to help them talk about their symptoms with a sleep specialist. To find a sleep specialist and refer your patients, use the Find a Sleep Specialist search at the top of this page.