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Epworth Sleepiness Scale

The Epworth Sleepiness Scale is a diagnostic tool designed to measure a patient’s general level of daytime sleepiness. Originally developed by Dr. Murray Johns in 1991, it helps clinicians assess the severity of excessive sleepiness, which can be a symptom of underlying sleep disorders such as obstructive sleep apnea, narcolepsy, or insomnia. Patients rate their likelihood of falling asleep during various everyday situations, providing an objective measure of their sleep propensity in a standardized manner.

The Epworth Sleepiness Scale is simple, quick to administer, and offers valuable insight into a patient’s quality of life. A high score may indicate the need for sleep studies or specialist referral. By using the Epworth Sleepiness Scale calculator below, physicians and patients can better quantify subjective feelings of tiredness and guide clinical decision-making for sleep health.

Epworth Sleepiness Scale Calculator

How likely are you to nod off or fall asleep in the following situations?

Value

A score of 11 or higher is generally considered abnormal and may suggest an underlying sleep disorder requiring further evaluation.

Epworth Sleepiness Scale Questionnaire

Patients rate their likelihood of dozing off during eight activities using a scale from 0 to 3, with the total score being the sum of all responses (maximum 24).

0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing

Situations:

1. Sitting and reading
2. Watching TV
3. Sitting inactive in a public place (e.g., theater or meeting)
4. As a passenger in a car for an hour without a break
5. Lying down to rest in the afternoon when circumstances permit
6. Sitting and talking to someone
7. Sitting quietly after a lunch without alcohol
8. In a car, while stopped for a few minutes in traffic

Scoring & Interpretation of Results

Each patient's total score offers a clinical snapshot of their daytime sleepiness:

0–5: Lower Normal Sleepiness
6–10: Higher Normal Sleepiness
11–12: Mild Excessive Sleepiness
13–15: Moderate Excessive Sleepiness
16–24: Severe Excessive Sleepiness

A score of 11 or higher is generally considered abnormal and may suggest an underlying sleep disorder requiring further evaluation. The scoring thresholds were originally developed by Dr. Murray Johns based on clinical observations and validation studies during the creation of the Epworth Sleepiness Scale. It is important to interpret the results in the context of the patient's overall clinical picture, as other medical, psychological, or lifestyle factors can influence daytime sleepiness.

Learn more on the BackTable ENT Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on the Epworth Sleepiness Scale and how to build your practice by listening to the BackTable Podcast.

Ep 210 Rethinking OSA: Role of the Nose with Dr. Keith Matheny and Dr. Ashwin Ananth

00:00 / 01:04

References

[1] Johns, M. W. "A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale." Sleep, 1991;14(6):540–545.
[2] Johns, M. W. "Reliability and factor analysis of the Epworth Sleepiness Scale." Sleep, 1992;15(4):376–381.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.