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Have you ever wondered if your daytime sleepiness is normal? From time to time, we all struggle with a little daytime fatigue. Perhaps you nod off while watching a movie or after a big meal, but how do you know when your daytime sleepiness is becoming excessive? Hypersomnia (daytime drowsiness) is one of the most common symptoms of many sleep disorders, including sleep apnea. Sleep apnea is a serious sleep disorder that can pose many long-term risks to your overall health, as well as rob you of a good night’s sleep. If you want to gauge whether your tiredness is normal fatigue after a long day, or a sign of something more serious, the Epworth Sleepiness Scale is a useful tool that can give you an idea. So, how does the Epworth Sleepiness Scale work?
How the Epworth Sleepiness Scale works
The ESS is a simple questionnaire often used by doctors during a holistic diagnosis process for sleep disorders, but you can also fill it out for yourself. It consists of eight questions posing different scenarios, and the patient ranks how likely they are to fall asleep in that situation, ranging from 0 (would never nod off) to 3 (high chance of nodding off). There are a total of 24 points possible, and if a patient scores higher than 10 points, it may be time to make lifestyle adjustments or seek medical attention. The scenarios it poses are:
- Sitting and reading
- Watching TV
- Sitting in a public place (going to the theater, attending a meeting, going to dinner, etc.)
- Being a passenger in a car for over an hour without a break
- Lying down to rest
- Sitting and talking with someone
- Sitting after a meal without alcohol
- Being stopped in traffic or at a stoplight in a car
Is the questionnaire accurate?
One of the limitations of the scale is that it is self-reported by the patient. People may over or underestimate their levels of tiredness, which can alter the score. While the questionnaire can be a good starting point for someone wondering if they have a sleep disorder, or a useful tool for a doctor diagnosing a patient, the scale alone isn’t enough to make a diagnosis, only to signal that you may not be getting enough sleep.
What’s next?
If you scored higher than 10 on the questionnaire, the CDC recommends that you try to get more sleep, change your sleep practices, or speak with a doctor to find the cause of your fatigue. Another important factor to consider alongside the ESS is any symptoms you may have. If your daytime sleepiness is accompanied by loud snoring, frequent urination, or headaches, you may be suffering from sleep apnea. In this case, the next step would be to conduct a sleep test. Sleep tests are offered in a variety of ways, from a full clinical polysomnography in a lab to convenient sleep tracking wearables you can use in the comfort of your own home. Whatever you choose, it’s always a good decision to investigate daytime fatigue.
Wondering if sleep apnea is affecting you? Take a few seconds to check out the Dumbo Health Sleep Quiz, and with a few simple questions, you can begin your treatment journey today.
Frequently Asked Questions
How long does it take to complete the Epworth Sleepiness Scale?
Most people finish in less than two minutes. The test is intentionally short so it can be used easily in both clinical and non-clinical settings.
Can the Epworth Sleepiness Scale be taken at home?
Absolutely. The ESS is designed as a self-assessment, so it can be done at home without medical supervision. Results should still be discussed with a healthcare provider for context.
Who developed the Epworth Sleepiness Scale?
It was created in 1991 by Dr. Murray Johns, a sleep medicine specialist in Melbourne, Australia. The tool was originally developed to standardize the measurement of daytime sleepiness in patients.
Can the ESS be used for children or teenagers?
The scale was validated for adults. Pediatric sleepiness often requires different assessment tools, though modified versions of the ESS have been explored in research.
Is the Epworth Sleepiness Scale used outside of sleep apnea?
Yes. The ESS is also applied in studies of narcolepsy, idiopathic hypersomnia, insomnia, and other neurological or psychiatric conditions where daytime fatigue is a concern.
Click here to fill out the Epworth Sleepiness Scale Calculator.
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