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Narcolepsy Screening for Pediatric Patients

Screening for sleep problems in pediatric patients is important, particularly in children with neurodevelopmental disorders.1 The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is a validated screening tool for use in pediatric patients 12 to 18 years of age.2,3

Measure Your Patient’s Sleepiness

ESS-CHAD2

Learn more about the ESS-CHAD|Download screening tools

Ask your patient how likely he or she has been able to fall asleep over the past month while doing the things that are described below (activities). Ensure each question is answered by the patient or his or her caregiver. If the patient has not done any of the activities over the past month, ask the patient to imagine how the situation would affect him or her.

Rate your chance of falling asleep in each activity:

Would Never
Fall Asleep
Slight Chance of Falling Asleep
Moderate Chance of Falling Asleep
High Chance of Falling Asleep
Sitting and reading

1 of 8

Sitting and watching TV or a video

2 of 8

Sitting in a classroom at school during the morning

3 of 8

Sitting and riding in a car or bus for about half an hour

4 of 8

Lying down to rest or nap in the afternoon

5 of 8

Sitting and talking to someone

6 of 8

Sitting quietly by yourself after lunch

7 of 8

Sitting and eating a meal

8 of 8

Reprinted with permission from Wang YG, Benmedjahed K, Lambert J, et al. Assessing narcolepsy with cataplexy in children and adolescents: development of a cataplexy diary and the ESS-CHAD. Nat Sci Sleep. 2017;9:201-211. Permission conveyed through Copyright Clearance Center, Inc.

Optional Information:

*The ESS-CHAD was validated for use with children ages 12 to 18; younger children may require assistance.2,3

Results

Your patient’s ESS-CHAD score is:

An ESS-CHAD score >10 suggests excessive daytime sleepiness.2,3,5 The ESS-CHAD score should be discussed with a sleep specialist.

Interpreting ESS-CHAD Scores3-5*

Normal levels of sleepiness

Excessive daytime sleepiness

High level of sleepiness suggestive of significant sleep disorder

0
10
16
24

*This screening tool is not intended to make a narcolepsy diagnosis or replace complete evaluation by a sleep specialist.


The content on this site is not meant to replace a conversation with a sleep specialist. A sleep specialist can evaluate for symptoms and make a diagnosis. A narcolepsy diagnosis should be established with a clinical interview and nighttime polysomnography (PSG) followed by a multiple sleep latency test (MSLT).6

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Patient/Caregiver Perspectives
  1. Maski K, Owens JA. Insomnia, parasomnias, and narcolepsy in children: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(11):1170-1181.
  2. Wang YG, Benmedjahed K, Lambert J, et al. Assessing narcolepsy with cataplexy in children and adolescents: development of a cataplexy diary and the ESS-CHAD. Nat Sci Sleep. 2017;9:201-211.
  3. Janssen KC, Phillipson S, O'Connor J, Johns MW. Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis. Sleep Med. 2017;33:30-35.
  4. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14(6):540-545.
  5. Johns M, Hocking B. Excessive daytime sleepiness: daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20(10):844-849.
  6. American Academy of Sleep Medicine. Central disorders of hypersomnolence. In: The International Classification of Sleep Disorders – Third Edition (ICSD-3) Online Version. Darien, IL: American Academy of Sleep Medicine; 2014.
Calculating
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