Epworth Sleepiness Scale

The Epworth Sleepiness Scale quantitfies the level of daytime sleepiness. A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy.

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

0 — no chance of nodding off
1 — slight chance of dozing
2 — moderate chance of sleeping
3 — high chance of falling asleep

Situations:

• Chance of Dozing or Sleeping
• Sitting and reading
• Watching TV
• Sitting inactive in a public place
• Being a passenger in a motor vehicle for an hour or more
• Lying down in the afternoon
• Sitting and talking to someone
• Sitting quietly after lunch (no alcohol)
• Stopped for a few minutes in traffic
  while driving
  

The Epworth Sleepiness Scale (ESS) was developed by Dr. Murray W. Johns at Epworth Hospital in Melbourne, Australia in the early 90s. The subjective test is intended to measure a person’s usual level of daytime sleepiness. The ESS asks the examinee to rate his or her propensity to doze off in eight different situations. The various likelihoods are ranked from zero to three as the likelihood increases, thus a maximum score on the ESS is 24. In general, scores above nine indicate the need for a sleep specialist. The score is claimed to reflect a person’s Average Sleep Propensity (ASP) which is different from fatigue or tiredness which is the focus of some other sleep scales (e.g. Stanford Sleepiness Scale). ASP is a measurement of a person’s general level of daytime sleepiness. ESS has been able to identify people with sleep apnea syndrome, narcolepsy and idiopathic hypersomnia making it a useful screening test. The ESS should not be used to compare subjects to one another which limits its use as a research tool; however, a patient’s score may be used to compare the effects of treatment or stressors in that same patient over time.

The Pittsburgh Sleep Quality Index

In the late 1980s doctors at the University of Pittsburgh medical school devised an index to help diagnose and evaluate sleep quality. Dubbed the Pittsburgh Sleep Quality Index (PSQI) this self-rated questionnaire looks at sleep quality and disturbances over a one-month interval. The results give numbers in seven categories: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction These numbers can be useful to psychiatrists and other doctors in calling out the nuances of the patient’s sleep disorders and patterns.

More on the Pittsburgh Index.

A recent study published in the journal Sleep showed that Epworth and PSQI scores tend to be stable when participants took the test over different times. The stability of the scores suggests that these scales have validity.

Sleep Disorders

Dyssomnias

Parsomnias