The Epworth Sleepiness Scale (ESS) is a subjective scale that measures an individual’s propensity to doze or fall asleep during 8 common daily activities to determine the level of daytime sleepiness.

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Features of the ESS

  • Purpose:

    Designed to measure general level of daytime sleepiness1

  • Population:

    All patients for whom the clinician may want to evaluate the level of daytime sleepiness1

  • Assessments:

    Measures the propensity to doze or fall asleep during 8 common daily activities, such as: sitting and reading; sitting inactive in a public place; sitting and talking to someone; sitting quietly after a lunch without alcohol; or in a car, while stopped for a few minutes in traffic1,2

  • Method:

    Patient self-report1

  • Time required:

    Consists of 8 questions and takes only a few minutes to complete1

  • Scoring:

    Propensity for dozing is rated for each situation on a 4-point scale, from 0, indicating “would never doze,” to 3, indicating a “high chance of dozing.” Adding the scores for each of the 8 questions yields a total score ranging from 0-24.1,2

  • Interpretation:

    An ESS score >10 suggests excessive daytime sleepiness (EDS).2 An ESS score ≥16 suggests a high level of EDS. Scores within this range are generally associated with significant sleep disorders, including narcolepsy.1 A high ESS score is suggestive of EDS only and is not diagnostic for a specific sleep disorder. Patients with EDS (ie, ESS >10) may need to be evaluated for a potential sleep disorder, including narcolepsy.1

A narcolepsy diagnosis should be established by a sleep specialist with a clinical interview and a nighttime polysomnogram (PSG) followed by a multiple sleep latency test (MSLT). A consistent sleep-wake schedule, including a minimum of 7 hours in bed, should be established for at least 1 week prior to MSLT and PSG, and documented by a sleep log or actigraphy.3

Two narcolepsy screening tools are now available in one app.
Learn More Learn More about the Narcolepsy Screener App

The Epworth Sleepiness Scale is from: 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.

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