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    • Screeners
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    • Diagnostic Challenges
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    • Modifiable Risks for CV Disease
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    • Management Considerations
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  • SYMPTOM SCREENERS:
  • MEASURING SLEEPINESS
  • EXPLORING SYMPTOMS

Screening for Narcolepsy Is Important

During appointments, ask your patients to complete the Epworth Sleepiness Scale (ESS) and/or the Swiss Narcolepsy Scale (SNS) and use the results to help guide your discussion.1,2

AASM provides quality measures for managing patients with narcolepsy3 Discover these approaches

AASM, American Academy of Sleep Medicine

Measure Your Patient's Sleepiness

Epworth Sleepiness Scale1

How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired? This refers to your usual way of life recently. Even if you haven’t done some of these things recently try to work out how they would have affected you.

Use the following scale to choose the most appropriate number for each situation.

It is important that you answer each item as best as you can.

No chance of dozing

Slight chance of
dozing

Moderate chance of 
dozing

High chance of  
dozing

Sitting and reading 1 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Watching TV 2 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting inactive in a public place 
(e.g., a theater or a meeting)
3 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

As a passenger in a car for an hour without a break 4 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Lying down to rest in the afternoon while circumstances permit 5 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting and talking to someone 6 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting quietly after a lunch without alcohol 7 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

In a car or bus, while stopped for a few minutes in traffic 8 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Higher scores are associated with more daytime sleepiness.

Total Score = 0

ESS © MW Johns 1990-1997. Used under License

For any information on the distribution rights for the ESS, please contact Mapi Research Trust, Lyon, France, Internet: https://eprovide.mapi-trust.org

The Epworth Sleeping Scale (ESS)

Your ESS score is:

0

An ESS score >10 suggests excessive daytime sleepiness.1 All patients with excessive daytime sleepiness should be evaluated by a sleep specialist.

Interpreting ESS Scores1,4*

0
10
16
24
Normal levels of sleepiness
Suggests excessive daytime sleepiness (EDS)
Suggests high level of EDS

Your patient’s scores are available as a PDF that includes the Narcolepsy Conversation Starter

Download Resultsdownload icon
Screen a pediatric patient

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

Please fill out all the questions on the screener to see your result.

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Optional Information

Gender:

CONTINUE

Download Results

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Explore Your Patient's Symptoms

Swiss Narcolepsy Scale2,5

Learn more about the SNS

|

Download screening tools

This tool was created to screen individuals for narcolepsy with cataplexy. Ask your patient to answer these questions.

Never

Rarely
(Less than once a month)

Sometimes 
(1-3 times a month)

Often 
(1-2 times a week)

Almost Always

How often are you unable to fall asleep? 1 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost Always

How often do you feel bad or not well rested in the morning? 2 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost Always

Never

I 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? 3 of 5

Never

I would like to, but cannot

1-2 times a week

3-5 times a week

Almost daily

Never

Rarely
(Less than once a month)

Sometimes 
(1-3 times a month)

Often 
(1-2 times a week)

Almost Always

How often have you experienced weak knees/buckling of the knees during emotions like laughing, happiness, or anger? 4 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost Always

How often have you experienced sagging of the jaw during emotions like laughing, happiness, or anger? 5 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost Always

Negative scores are suggestive of narcolepsy with cataplexy.

Total Score = 0

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

The Swiss Narcolepsy Scale (SNS)

Your SNS score is:

0

An SNS calculated score that is <0 is suggestive of narcolepsy with cataplexy.2,6,7 All patients with an SNS score that is less than 0 should be evaluated by a sleep specialist.

Interpreting SNS Scores2,6,7,*

-50
-40
-30
-20
-10
0
6
Suggests narcolepsy with cataplexy
Not suggestive of narcolepsy with cataplexy

Your patient’s scores are available as a PDF that includes the Narcolepsy Conversation Starter

Download Resultsdownload icon
Screen a pediatric patient

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

Please fill out all the questions on the screener to see your result.

BACK

Optional Information

Gender:

CONTINUE

*These screening tools are 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).7

READ NEXT: Narcolepsy diagnostic criteria

  1. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
  2. Sturzenegger C, Bassetti CL. The clinical spectrum of narcolepsy with cataplexy: a reappraisal. J Sleep Res. 2004;13(4):395-406.
  3. Krahn LE, Hershner S, Loeding LD, et al. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med. 2015;11(3):335-355.
  4. Johns M, Hocking B. Excessive daytime sleepiness: daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20(10):844-849.
  5. Sturzenegger C, Baumann CR, Kallweit U, Lammers GJ, Bassetti CL. Swiss Narcolepsy Scale: a valid tool for the identification of hypocretin-1 deficient patients with narcolepsy. J Sleep Res. 2014;23(suppl 1):297.
  6. Bassetti CL. Spectrum of narcolepsy. In: Baumann CR, Bassetti CL, Scammell TE, eds. Narcolepsy: Pathophysiology, Diagnosis, and Treatment. New York, NY: Springer Science+Business Media; 2011:309-319.
  7. 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.
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