Questionnaire
Epworth Sleepiness Scale
ESS
Eight everyday situations rated for dozing likelihood — the most widely used measure of subjective daytime sleepiness.
What it measures
Subjective daytime sleepiness. Eight items rated 0–3 for chance of dozing. Total score 0–24. Higher scores indicate greater sleepiness; complements but doesn't replace objective sleep studies.
Mechanism
Why moving this marker matters
Excessive daytime sleepiness is the cardinal symptom of inadequate or fragmented sleep — usefully captured for screening sleep apnea, narcolepsy, and insufficient sleep syndrome.
Guideline targets
What major guidelines recommend
Johns 1991 validation
≥11 indicates excessive daytime sleepiness warranting evaluation
How to measure
The test, where to get it, when to repeat
Method
Self-administered, 2–3 minutes. Read each item, rate dozing chance from 0 (would never doze) to 3 (high chance of dozing).
Where
Public domain instrument. Used clinically alongside STOP-Bang in sleep workups.
Typical cost
Free.
Fasting
Not required
When to test
AASM 2017
Used as part of OSA screening alongside STOP-Bang.
Where to score
Completing this questionnaire
Self-administered — your GP or mental-health professional can confirm scoring and discuss results.
The instrument
Items shown for reference
Validated questionnaires are shown here as reference. Read each item and count your own answers — Healicus does not compute or store a score. This keeps the page on the educational side of the EU MDR line; the instrument itself remains the validated tool.
- 1
Sitting and reading
0 (never) — 3 (high chance)
- 2
Watching TV
0 — 3
- 3
Sitting inactive in a public place (theatre, meeting)
0 — 3
- 4
As a passenger in a car for an hour without a break
0 — 3
- 5
Lying down to rest in the afternoon when circumstances permit
0 — 3
- 6
Sitting and talking to someone
0 — 3
- 7
Sitting quietly after lunch without alcohol
0 — 3
- 8
In a car, while stopped for a few minutes in traffic
0 — 3
Scoring (do this yourself)
Sum the eight item scores. Per Johns 1991: 0–10 typically normal; 11–14 mild excessive daytime sleepiness; 15–17 moderate; 18–24 severe. Scores ≥11 warrant evaluation for sleep disorders. The scale is a screening instrument, not a diagnostic tool — a high score should prompt further workup (sleep study, STOP-Bang) rather than self-diagnosis.
If you prefer an interactive calculator, the published MDCalc tool is available here ↗ — operated and maintained by a third party.
Context
Reading the numbers
Not specific to any one sleep disorder. Useful as a screening trigger and as a longitudinal marker before/after treatment of identified sleep conditions.
Caveats
Subjective and self-report — patients with chronic sleepiness may underestimate. Not a diagnostic instrument.
Practices
What's been shown to influence this marker
Sleep apnea screening
Program·Untreated obstructive sleep apnea drives cardiovascular and metabolic risk. Screen if you snore loudly, are tired despite enough hours, or have hypertension.
Why
Obstructive sleep apnea (OSA) is common (~10-15% of adults), often undiagnosed, and causally linked to hypertension, cardiovascular events, cognitive decline, and all-cause mortality. STOP-BANG is the most validated screening questionnaire. Diagnosis is by polysomnography or home sleep apnea testing. CPAP and other treatments substantially reduce risk in moderate-severe OSA.
The program
- 1
Take the STOP-BANG questionnaire (free online).
- 2
If 3+ positives, ask your GP for a sleep study referral.
- 3
Home sleep apnea testing or in-lab polysomnography confirms the diagnosis.
- 4
If moderate-severe, options include CPAP, mandibular advancement device, weight loss, positional therapy.
- 5
Re-screen if sleep quality degrades again after weight or lifestyle change.
Practical
Cadence
One-time screening; re-test if symptoms return
What you'll need
STOP-BANG questionnaire (online, 8 yes/no questions)
Ideal for
Loud snorers, witnessed apneas, daytime fatigue despite adequate sleep duration, hypertension, large neck circumference, BMI ≥35.
Markers this may influence
Evidence
See also
Related markers
Take to your physician
Worth discussing
- If your score is ≥11 (or has risen from a prior reading), whether further sleep workup is appropriate.
- Whether your sleepiness aligns better with sleep apnea, insufficient sleep, or another cause.
Sources
Cited literature
Edited by Carl Pöhl, MD · Healicus editorial
Last reviewed May 2026
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