Epworth Sleepiness Scale
Evaluation of excessive daytime sleepiness (Screening for OSA).
The Epworth Scale: Screening for Sleep Apnea
The Epworth Sleepiness Scale (ESS) is a globally validated questionnaire used in sleep medicine and pulmonology. Its primary purpose is to measure a person's general level of daytime sleepiness.
Why use this scale?
This quick, patient-administered questionnaire is the first diagnostic step when there is a suspicion of:
- Obstructive Sleep Apnea (OSA): The most common cause of a high Epworth score (sleep fragmentation due to breathing pauses).
- Narcolepsy: A neurological disorder characterized by irrepressible sleep attacks.
- Idiopathic Hypersomnia: Excessive daytime sleepiness without an obvious respiratory cause.
Clinical Guidelines (Polygraphy)
An Epworth score of 10 or greater is considered pathological. It formally justifies performing a sleep study (Ventilatory polygraphy or Polysomnography) to confirm the diagnosis of OSA and quantify the Apnea-Hypopnea Index (AHI), in order to initiate appropriate treatment such as Continuous Positive Airway Pressure (CPAP).
Epworth Score Interpretation
| Total Score | Sleepiness Evaluation | Recommendation |
|---|---|---|
| 0 - 8 | Normal (No deficit) | Good sleep hygiene. |
| 9 - 14 | Abnormal sleepiness (Mild-Mod) | Specialist advice, OSA screening. |
| 15 - 24 | Severe sleepiness (Pathological) | Urgent polysomnography required. |
References:
1. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
[Oxford Academic]
2. Patil SP, et al. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2019.
[AASM Guidelines]
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