How the Epworth Sleepiness Scale Assesses Sleep Disorders

If you find yourself falling asleep during the day, you might question whether you are too sleepy. There is a simple screening tool used by sleep doctors to identify individuals who suffer from excessive daytime sleepiness. Learn the questions that are part of it and how they may help to identify problems associated with sleep disorders, like sleep apnea and narcolepsy.

The Epworth Sleepiness Scale

The Epworth sleepiness scale is a questionnaire that is routinely used to assess the degree of an individual’s sleepiness. It is a subjective measure completed by patients. However, it can be helpful in quantifying one's sleepiness over time.

The scale is completed by an individual and given to his or her doctor. It is often used as a screening test for sleepiness or to monitor response to treatment.

Assessment

The scale measures an individual’s likelihood of falling asleep in routine life situations. Often, there is a prompt like, "How likely are you to doze in the following activities?" This assessment reflects the recent past while observing your usual routines.

Other situations described in the questionnaire include:

• Sitting and reading
• Watching television
• Sitting inactively in a public place
• Riding as a passenger in a car for one hour without a break
• Lying down to rest in the afternoon when circumstances permit
• Sitting and talking with someone
• Sitting quietly after lunch without alcohol
• Sitting in a car as the driver while stopped for a few minutes in traffic

Calculating Your Score

For each situation, a score is assigned that indicates the likelihood a person would fall asleep. The scores range from zero to three:

• 0 = would never doze
• 1 = slight chance of dozing
• 2 = moderate chance of dozing
• 3 = high chance of dozing

The total score can range from zero to 24. Higher scores are correlated with increased sleepiness.

This correlation and validity have been established with a large study comparing the results of the Epworth scale to the ability to fall asleep during a Multiple Sleep Latency Test (MSLT).

What Your Score Means

The average score among healthy adults is six. In general, scores higher than eight indicate excessive sleepiness. Most sleep physicians use 10 and higher as indicating someone is too sleepy.

Much higher scores may occur in patients with narcolepsy. The numbers may also be elevated in untreated idiopathic hypersomnia or, most commonly, in sleep apnea.

Though the Epworth sleepiness scale is easy to administer and adds some basic information about sleepiness, it is admittedly a measure with a somewhat limited purpose. As it depends on your subjective experience, it may not fully reflect your actual degree of impairment.

For example, when people have insomnia, their scores are usually lower. Thus, high scores alone are not sufficient to diagnose sleep apnea.

A Word From Verywell

If you are concerned about the quality of your sleep or your degree of daytime sleepiness, start by speaking with a sleep specialist. After reviewing your symptoms, appropriate testing can be arranged to help select the best treatment to help you feel better rested and alert throughout the day, no matter your activities.