Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) is a useful tool to help diagnose obstructive sleep apnoea (OSA). Feeling very sleepy during the day is a common symptom of OSA.

Epworth Sleepiness Scale (ESS)

If you're worried about how tired you feel during the day, think about the questions below. It may be helpful to ask a friend or family member to help you with your answers.

How likely are you to fall asleep in the following everyday situations? Consider this separately from just feeling tired.

Think about the following everyday situations, even if you haven't done these things recently. How might they affect you?

Choose the most appropriate response for each situation:

  • would never fall asleep
  • slight chance of falling asleep
  • moderate chance of falling asleep
  • high chance of falling asleep
Situation Chance of falling asleep

Sitting and reading

Watching TV

Sitting in a public place (e.g. a cinema or a meeting)

As a passenger in a car for an hour without a break

Lying down to rest during the day when possible

Sitting and talking to someone

Sitting after eating a meal without having drunk alcohol

In a car or bus while stopped in traffic for a few minutes

Total

What does my score mean?

The results are:

  • 0-5 lower normal daytime sleepiness
  • 6-10 normal daytime sleepiness
  • 11-12 mild daytime symptoms
  • 13-15 moderate daytime symptoms
  • 16-24 severe daytime symptoms

There are many reasons why you might feel sleepy during the day.

A few common causes of sleepiness are:

  • not sleeping well enough
  • an unhealthy lifestyle, such as not eating well or not getting much exercise
  • stress, feeling unwell or side effects from some medicines
  • hormonal changes, such as puberty, pregnancy or the menopause.

A total score between 11 and 24 might suggest you're feeling unusually sleepy during the day.

When should I contact my GP?

The Epworth Sleepiness Scale cannot tell you whether you have OSA on its own.

You should always speak to your GP if your sleepiness is affecting your daily life, or if you're concerned about your sleep. You can share your survey results with your GP to help them understand your symptoms.

Based on your scores and how sleepiness affects you, your GP may refer you to a sleep clinic. This is so you can do further tests, like a sleep study, which can help to diagnose OSA. If the results from the sleep study show you have OSA, they can help to identify whether your OSA is mild, moderate or severe.

We have more information on common symptoms of OSA and diagnosing OSA.

 

Copyright © MW Johns 1990-1997. Used under license. Sample copy - do not use without permission. Contact information and permission to use: Mapi Research Trust, Lyon, France eprovide.mapi-trust.org. A version for adolescents has also been created, ESS-CHAD (copyright © MW Johns, 1990, 2015).

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