Epworth Sleepiness Scale

Resources for the Comprehensive Geriatric Assessment based

Proactive and Personalised Primary Care of the Elderly

ESS

Purpose : Measure of a subject's usual level of daytime sleepiness or average sleep propensity.

The ESS asks people to rate their usual chances of dozing off or falling asleep in 8 different situations or activities that most people engage in as part of their daily lives, although not necessarily every day.

Admin time : 5 min.

User Friendly : High

Administered by : self or GP

Content : The client self-rates on how likely it is that he/she would doze in eight different situations. Scoring of the answers is 0-3, with 0 being “would never doze” and 3 being “high chance of dozing”. A sum of 10 or more from the eight individual scores reflects above normal daytime sleepiness and need for further evaluation.

In general ESS scores can be interpreted 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

Author : Johns M, 1990 and 1997

A license is required to use the ESS, whether or not a license fee is payable.

Students, physicians, clinical practice, not-funded academic users may access the questionnaire and/or its available translations directly subject to registration as a user (see tutorial).

For funded academic users, healthcare organizations, commercial users & IT companies fees may apply.

All matters in relation to use ESS, the issuance of licenses for its use, and the provision of translations into languages other than English are handled by Mapi Research Trust, in France. They are Dr Johns’ agents, worldwide.

Epworth Sleepiness Scale

Epworth Sleepiness Scale - online

Epworth Sleepiness Scale

Advantages:

Quick and easy to administer
The psychometric properties of the ESS have been investigated widely

Limitations:

Because ESS item-scores are based on subjective reports, they can be influenced by the same sources of bias and inaccuracy as any other such reports. The ESS should not be used in isolation in circumstances where the scores could determine outcomes with potential legal implications, such as granting or withholding a driver’s license. Confirmatory evidence of ‘excessive daytime sleepiness’ or an increased risk of a drowsy road-crash should be sought from other sources too.
The ESS does not usually enable accurate predictions to be made of a person’s level of drowsiness, and hence their crash-risk, when driving a vehicle at some particular time. However, there may be an exception to this among people with very high ESS scores (>15), whose ASP (average sleep propensity) is very high under most circumstances.
The ESS does not distinguish which factors, or which sleep disorders, have caused any particular level of ASP. The ESS is not a diagnostic tool by itself. Nor does it assess other aspects of a person’s sleep habits, for which other methods are available.
The ESS is not suitable for use among people with serious cognitive impairment. Nor is it suitable for measuring rapid changes in sleep propensity over periods of hours, eg. to demonstrate the short-term sedative effects of a drug, or to assess the circadian rhythm of sleep propensity.

Accuracy :

Sensitivity (93.5%) and specificity (100%) with a cut-off score > 10. (Johns MW,2001)

This Tool is used in Sleep Disorders

Back To : Sleep Disorders

Sleep Disorders is one of 4 Geriatric Syndromes

Back To : Geriatric Syndromes

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