A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Abstract
The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
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Daytime sleepiness was assessed using a modified version of the Epworth Sleepiness Scale.
“Daytime sleepiness was assessed using a modified version of the Epworth Sleepiness Scale [26]: Students rated how likely they would fall asleep in three situations (in school, while watching television, and when riding as a car passenger) on a 4-point Likert scale, resulting in a total score, with higher scores reflecting higher daytime sleepiness.”
From The Power of Flexible School Start Times: (2026) · cites this paper as [26]
ESS measures daytime sleepiness.
“ESS: Epworth Sleepiness Scale [42], to measure daytime sleepiness.”
From Efficacy study comparing a CBT-I developed for shift workers (CBT-I-S) to standard CBT-I (cognitive behavioural therapy for insomnia) on sleep onset latency, total sleep time, subjective sleep quality, and daytime sleepiness: study protocol for a parallel group randomised controlled trial with online therapy groups of seven sessions each (2024) · cites this paper as [42]
ESS Cronbach's α is acceptable to good with values between 0.73 and 0.88.
“Cronbach’s α is acceptable to good with values between 0.73 and 0.88.”
From Efficacy study comparing a CBT-I developed for shift workers (CBT-I-S) to standard CBT-I (cognitive behavioural therapy for insomnia) on sleep onset latency, total sleep time, subjective sleep quality, and daytime sleepiness: study protocol for a parallel group randomised controlled trial with online therapy groups of seven sessions each (2024) · cites this paper as [42]
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- Authors
- Johns, M. W.
- Affiliations
- Epworth Hospital (AU)
- Corresponding author
- Johns, Murray W.
- ORCID
- Johns, Murray W.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 1991-11-01
- Volume
- 14
- Issue
- 6
- Pages
- 540-545
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W197066864
- Cited by
- 17,364
- References
- 19
- Citations by year
- 2026: 845 · 2025: 955 · 2024: 991 · 2023: 964 · 2022: 1030 · 2021: 1116 · 2020: 1035 · 2019: 941 · 2018: 848 · 2017: 823 · 2016: 853 · 2015: 757 · 2014: 738 · 2013: 698 · 2012: 656
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- Epworth Sleepiness Scale, daytime sleepiness, self-report questionnaire, sleep disorders, obstructive sleep apnea, narcolepsy, idiopathic hypersomnia, multiple sleep latency test, sleep latency, respiratory disturbance index, oxygen saturation, snoring
- MeSH terms
- Adult, Arousal, Circadian Rhythm, Female, Humans, Disorders of Excessive Somnolence, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Narcolepsy, Psychometrics, Restless Legs Syndrome, Sleep Apnea Syndromes, Sleep Wake Disorders, Snoring, Wakefulness
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