Epworth Sleepiness Scale

Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) is a self-administered questionnaire designed to measure daytime sleepiness and help diagnose sleep disorders. Developed in 1991 by Dr. Murray Johns at the Epworth Hospital in Melbourne, Australia, the ESS has become a widely used tool for evaluating the severity of excessive sleepiness and assessing the effectiveness of treatment for various sleep disorders.

Purpose

The primary purpose of the Epworth Sleepiness Scale is to provide a subjective measure of daytime sleepiness, which can be an indicator of underlying sleep disorders such as sleep apnea, narcolepsy, or insomnia. The ESS is particularly useful in identifying excessive daytime sleepiness, a common symptom in many sleep-related conditions. By assessing the degree of sleepiness, healthcare professionals can better understand a patient's sleep quality and determine appropriate treatment plans.

Questionnaire

The Epworth Sleepiness Scale questionnaire consists of eight situations that individuals may encounter during their daily routine. Participants rate their likelihood of dozing off or falling asleep in each scenario on a scale of 0 to 3:

• 0 - No chance of dozing
• 1 - Slight chance of dozing
• 2 - Moderate chance of dozing
• 3 - High chance of dozing

The situations included in the questionnaire are:

• Sitting and reading
• Watching TV
• Sitting inactive in a public place (e.g., theater, 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

The total score is calculated by summing the scores for each situation, ranging from 0 to 24.

Interpretation

The interpretation of the Epworth Sleepiness Scale is as follows:

• 0-5: Lower normal daytime sleepiness
• 6-10: Higher normal daytime sleepiness
• 11-12: Mild excessive daytime sleepiness
• 13-15: Moderate excessive daytime sleepiness
• 16-24: Severe excessive daytime sleepiness

Scores above 10 typically indicate excessive daytime sleepiness, which may warrant further investigation by a healthcare professional to determine the presence of a sleep disorder.

Limitations

While the Epworth Sleepiness Scale is a valuable tool for measuring daytime sleepiness, it is important to consider its limitations:

• Subjectivity: The ESS relies on the individual's subjective assessment of their sleepiness, which may be influenced by personal biases or inaccuracies in recollection.
• Lack of Context: The ESS does not account for factors that may contribute to sleepiness, such as sleep duration, sleep quality, or the presence of comorbid conditions.
• Not Diagnostic: The ESS is not a diagnostic tool; it is used to quantify daytime sleepiness, but it does not identify specific sleep disorders.

References

• Johns MW. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540-5. [1]

Summary

The Epworth Sleepiness Scale (ESS) is a scale intended to measure daytime sleepiness that is measured by use of a very short questionnaire. This can be helpful in diagnosing sleep disorders. It was introduced in 1991 by Dr Murray Johns of Epworth hospital in Melbourne, Australia.

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