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Epworth Sleepiness Scale
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About Epworth Sleepiness Scale
Scale Name
Epworth Sleepiness Scale
Author Details
Murray W. Johns
Translation Availability
English, Urdu
Background/Description
The Epworth Sleepiness Scale (ESS) is a widely adopted self-report questionnaire designed to measure daytime sleepiness, a key indicator of sleep disorders such as obstructive sleep apnea, narcolepsy, or insomnia. Developed by Murray W. Johns in 1991 at the Epworth Hospital in Melbourne, Australia, the ESS was created to provide a simple, standardized tool to quantify an individual’s propensity to fall asleep in everyday situations. Its development addressed the need for a reliable measure to assess excessive daytime sleepiness, which can significantly impair quality of life, cognitive performance, and safety, particularly in activities like driving.
The ESS consists of eight items, each describing a common situation (e.g., sitting and reading, watching TV, or being a passenger in a car) where respondents rate their likelihood of dozing off on a 4-point scale (0 = “would never doze” to 3 = “high chance of dozing”). Total scores range from 0 to 24, with higher scores indicating greater sleepiness; scores above 10 suggest abnormal sleepiness warranting further evaluation. Its straightforward design allows for quick completion, making it practical for clinical settings, sleep clinics, and research studies. Validated across diverse populations, the ESS is sensitive to changes following treatments like continuous positive airway pressure (CPAP) or behavioral interventions.
Psychologists, sleep specialists, and primary care providers value the ESS for its ability to screen for sleep-related issues and guide diagnostic processes. Its focus on functional impact helps clinicians identify patients at risk for sleep disorders, facilitating referrals for polysomnography or tailored interventions. The scale’s extensive translations ensure its global applicability, enabling professionals to address sleep health across cultures with precision and empathy.
Administration, Scoring and Interpretation
- Obtain a copy of the Epworth Sleepiness Scale from a reputable source, such as peer-reviewed journals, authorized sleep research platforms, or the official ESS website, ensuring proper use permissions.
- Explain the purpose of the ESS to the respondent, noting that it measures daytime sleepiness to help identify potential sleep issues and inform care.
- Provide instructions, asking the respondent to rate each of the eight situations based on their usual likelihood of dozing over the past month, using the 0-3 scale.
- Approximate time for completion is about 2-5 minutes, owing to its concise format and clear questions.
- Administer the scale in a quiet, comfortable setting, using paper or digital formats, to encourage accurate and thoughtful responses.
Reliability and Validity
The Epworth Sleepiness Scale exhibits robust psychometric properties, supporting its widespread use in clinical and research contexts. Internal consistency is satisfactory, with Cronbach’s alpha values ranging from 0.73 to 0.88, indicating good cohesion across its eight items. Test-retest reliability is strong, with correlations of 0.82-0.90 over intervals of several weeks in stable populations, reflecting consistent measurement of sleepiness.
Convergent validity is demonstrated by moderate to strong correlations with objective sleep measures, such as the Multiple Sleep Latency Test (r = 0.50-0.70), and other subjective scales like the Pittsburgh Sleep Quality Index (r = 0.60-0.75). Discriminant validity is supported by weaker associations with unrelated constructs, such as depression (r < 0.40), though some overlap exists due to sleep’s psychological impact. Criterion validity is evidenced by its ability to distinguish individuals with sleep disorders (e.g., sleep apnea) from healthy controls and its sensitivity to treatment effects, such as reduced scores post-CPAP therapy. These qualities, as reported by Johns (1991) and subsequent studies, affirm the ESS’s reliability and validity.
Available Versions
08-Items
Reference
Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. sleep, 14(6), 540-545.
Important Link
Scale File:
Frequently Asked Questions
What does the ESS measure?
It measures daytime sleepiness and the likelihood of dozing in daily situations.
Who can use the ESS?
Sleep specialists, psychologists, and clinicians screening for sleep disorders.
How long does the ESS take to complete?
It takes about 2-5 minutes.
Can the ESS diagnose sleep disorders?
No, it screens for sleepiness but requires further testing for diagnosis.
Is the ESS sensitive to treatment changes?
Yes, it detects improvements from interventions like CPAP.
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