Epworth Sleepiness
Scale Test
The Epworth Sleepiness Scale (ESS) is the gold-standard clinical screening tool for excessive daytime sleepiness. Answer 8 questions about your likelihood of dozing in everyday situations and get your validated score with clinical interpretation in under 2 minutes.
The Epworth Sleepiness Scale is scored 0โ24. A score of 0โ10 is normal. Scores of 11โ12 indicate mild, 13โ15 moderate, and 16โ24 severe excessive daytime sleepiness. Any score above 10 warrants evaluation for sleep apnea, narcolepsy, or insufficient sleep.
Murray Johns, MD
validated scale
10+ = see a doctor
reliability (r=0.82)
Take the Epworth Sleepiness Scale
Rate your chance of dozing in each situation based on your usual daily life โ not just today. Select 0โ3 for all 8 questions.
How likely are you to doze off?
Rate each situation 0โ3. Complete all 8 questions for your score.
Epworth Score Severity Bands
Based on the original Johns 1991 validation study and AASM clinical guidance. A score above 10 is the standard clinical threshold for excessive daytime sleepiness.
Typical for healthy, well-rested adults. No significant daytime sleepiness. Maintain current sleep habits and consistent schedule.
Still within normal range but at the upper end. May benefit from reviewing sleep duration, consistency, and sleep hygiene habits.
Above the clinical threshold. Suggests insufficient sleep or early sleep disorder. Sleep hygiene review and GP consultation recommended.
Associated with obstructive sleep apnea, hypersomnia, and circadian rhythm disorders. Prompt clinical evaluation strongly recommended.
Strongly associated with severe OSA, narcolepsy, and idiopathic hypersomnia. Urgent sleep specialist referral and polysomnography indicated.
About Excessive Daytime Sleepiness
Excessive daytime sleepiness (EDS) affects an estimated 10โ20% of adults and is associated with significant health, safety, and productivity consequences.
What is Excessive Daytime Sleepiness?
EDS is persistent difficulty staying awake despite adequate sleep opportunity. It is distinct from normal tiredness and is a hallmark symptom of multiple sleep disorders including OSA and narcolepsy.
Sleep Apnea & ESS
OSA is the most common cause of EDS. Repeated apnoeic events fragment sleep architecture. Mean ESS in untreated moderate-severe OSA is 11โ16. CPAP treatment reduces ESS by 4โ5 points on average.
Narcolepsy & EDS
Narcolepsy type 1 typically presents with ESS scores of 17โ21, alongside cataplexy, sleep paralysis, and hypnagogic hallucinations. Average time to narcolepsy diagnosis is 8โ10 years.
EDS & Safety Risks
EDS increases road accident risk by 2โ7ร and workplace accidents by 1.5โ2ร. ESS โฅ16 is associated with driving impairment comparable to 0.05% blood alcohol concentration.
How the ESS Was Developed
Dr. Murray W. Johns developed the ESS at Epworth Hospital, Melbourne, in 1991. The initial validation included 180 subjects. The scale has since been translated into over 52 languages and used in thousands of clinical trials worldwide.
ESS vs Objective Tests
The Multiple Sleep Latency Test (MSLT) measures objective sleep onset latency in a controlled setting. The ESS correlates moderately with MSLT (r โ 0.4). ESS screens for sleepiness; MSLT is used for definitive diagnosis.
Epworth Sleepiness Scale โ FAQs
Clinical answers to the most searched questions about the ESS, scoring, and what to do with your result.
The Epworth Sleepiness Scale (ESS) is a validated 8-question self-administered questionnaire developed by Dr. Murray W. Johns at Epworth Hospital, Melbourne, Australia, first published in Sleep in 1991. It measures daytime sleepiness by asking how likely you are to doze in 8 common sedentary situations. Scores range 0โ24. It is the most widely used daytime sleepiness screening tool in clinical sleep medicine worldwide, translated into over 52 languages.
A normal ESS score is 0โ10. Scores of 0โ5 indicate lower normal daytime sleepiness โ typical for healthy adults. Scores of 6โ10 are higher normal but still typical. Scores of 11โ12 = mild, 13โ15 = moderate, and 16โ24 = severe excessive daytime sleepiness. Any score above 10 is above the clinical threshold and warrants further evaluation.
Each of the 8 questions is scored 0โ3: 0 = would never doze, 1 = slight chance, 2 = moderate chance, 3 = high chance of dozing. The total ESS score is the sum of all 8 responses, maximum 24. All 8 questions must be answered. The scale takes approximately 2 minutes to complete.
A score above 10 indicates excessive daytime sleepiness (EDS). Scores 11โ15 are most commonly associated with insufficient sleep, obstructive sleep apnea, depression, and circadian rhythm disorders. Scores 16โ24 are strongly associated with severe OSA, narcolepsy, and idiopathic hypersomnia. A high ESS does not diagnose any specific condition โ it signals that professional evaluation is needed.
No โ the ESS cannot diagnose sleep apnea. It is a validated screening tool that identifies excessive daytime sleepiness, one symptom of OSA. Diagnosis of obstructive sleep apnea requires polysomnography (PSG) or a home sleep apnea test (HSAT), with an AHI โฅ5 events/hour confirming diagnosis. A high ESS should prompt GP referral for formal sleep evaluation.
The ESS has good test-retest reliability (r = 0.82) and internal consistency (Cronbach’s ฮฑ = 0.73โ0.88). It correlates significantly with objective sleep latency measures including the MSLT, though correlation is moderate (r โ 0.4). It is best used as an initial screening tool alongside clinical interview, not as an isolated diagnostic metric.
Continue Your Sleep Assessment
The ESS measures daytime sleepiness. Use these tools to screen for sleep apnea risk and optimise your sleep schedule.