Epstein Sleepiness Scale | Daytime Tiredness Check

Feeling sleepy during the day every now and then is normal. When that drowsy fog shows up most days, though, it can point toward a sleep problem that needs attention. The epstein sleepiness scale gives a quick way to put numbers on that feeling and share it with a doctor.

In medical papers, the name most often used is the Epworth Sleepiness Scale (ESS), created by sleep physician Murray Johns at Epworth Hospital in Melbourne. You will sometimes see it called the “Epstein Sleepiness Scale,” especially in summaries and reports, but the questions and scoring are the same. The scale does not give a diagnosis by itself; it simply shows how likely you are to doze in common daily situations.

Epstein Sleepiness Scale Basics And Who It Helps

The scale asks how likely you are to fall asleep, not just feel tired, in eight everyday settings. Each setting gets a score from 0 to 3. You add those numbers to get a total between 0 and 24. Higher totals point toward stronger daytime sleepiness and raise the chance that an underlying sleep disorder is in play.

Eight Everyday Situations The Scale Asks About

The situations on the questionnaire were chosen because many people face them in normal life. They do not require special equipment or a clinic visit. That makes the epstein sleepiness scale handy both in clinics and at home before an appointment.

TABLE #1: within first 30%, 8+ rows, 3 columns

Daily Situation	What You Rate	Example Of Nodding Off
Sitting And Reading	How often your eyes close when reading a book or article	Re-reading the same line because your mind drifts
Watching Television	How likely you are to drift off during a show	Missing parts of a program and needing to rewind
Sitting Quietly In A Public Place	Sleepiness in meetings, classes, or waiting rooms	Head dropping while someone talks at the front of a room
Passenger In A Car For An Hour	How drowsy you get as a passenger on a longer ride	Needing to fight to keep your eyes open between stops
Lying Down To Rest In The Afternoon	How quickly rest turns into actual sleep	Closing your eyes for a “short break” and waking up later
Sitting And Talking To Someone	Whether you can stay alert during normal conversation	Feeling your thoughts fade while a friend speaks
Sitting Quietly After Lunch	Sleepiness during the post-meal slump without alcohol	Struggling to focus on work in the early afternoon
Stopped In Traffic While Driving	How likely you are to nod off at red lights	Eyes closing for a moment while waiting for the light to change

For each row, you choose a number from 0 (no chance of dozing) through 3 (high chance of dozing). The idea is to think about your usual life over recent weeks, not a single bad night. A single rough shift at work can leave anyone tired; scores reflect patterns.

Who Commonly Uses This Scale

Doctors, nurse practitioners, and sleep technologists often hand out this questionnaire to adults who complain of snoring, trouble staying awake, unrefreshing sleep, or trouble at work due to tiredness. It shows up in research on obstructive sleep apnea, narcolepsy, restless legs syndrome, and shift-work related sleep problems.

People also fill it out themselves at home before seeing a clinician. Some hospital and clinic sites let you complete an online version and bring the score to your visit, and the
official Epworth Sleepiness Scale site
explains the background of the questionnaire and how the total is used in practice.

Epstein Sleep Scale For Everyday Drowsiness

When people hear “sleepiness scale,” they sometimes picture a lab test with wires and machines. This questionnaire is different. It is a short, subjective list filled out on paper or on a screen. The score depends entirely on your own sense of how often you doze off.

How The Questions Are Scored

Each of the eight situations gets a number from 0 to 3. The options usually look like this:

• 0 – would never doze
• 1 – small chance of dozing
• 2 – moderate chance of dozing
• 3 – high chance of dozing

You simply pick the number that matches how you usually feel in that situation. Then you add all eight numbers. A person who scores 0 on every item has no reported daytime sleepiness. Someone who scores 3 on every item reaches the maximum of 24.

Why Honest Answers Matter

It can feel tempting to “underplay” sleepiness, especially for people who pride themselves on pushing through long days. Some worry that admitting drowsiness will affect their job or driving. On the other side, someone who is scared after reading about sleep disorders might give every item the highest score without thinking through each setting.

Try to answer somewhere in the middle of those extremes. Think about the past few weeks, not just the last night or two. If you often fight to stay awake in quiet rooms or during movies, that belongs in your score, even if you keep going with coffee or energy drinks.

How The Score Is Calculated

Once you have circled all eight numbers, you add them together. The total sits between 0 and 24. Doctors then place that total into broad ranges. Different clinics use slightly different cutoffs, yet the pattern is similar across guides from major hospitals and sleep societies.

Typical Score Ranges On The ESS

Medical sources often describe these score bands when they explain the questionnaire. One patient-friendly summary, for instance, notes that scores from 0 to 10 usually fall in the “normal” range, while higher numbers raise concern for excessive daytime sleepiness. A
Cleveland Clinic guide to the Epworth sleepiness scale
breaks that “high” end down into mild, moderate, and severe levels based on the exact total.

TABLE #2: after 60%, 3 columns

Total ESS Score	Sleepiness Level	Common Next Step
0–5	Lower daytime sleepiness	No sleep disorder study in many cases, unless other symptoms stand out
6–10	Higher end of normal	Doctor may ask about schedule, caffeine, and bedtime habits
11–12	Mild excessive sleepiness	Often triggers closer review and possible referral to a sleep clinic
13–15	Moderate excessive sleepiness	Objective tests like overnight sleep study or daytime nap test may be suggested
16–24	Severe excessive sleepiness	Doctors usually move quickly to rule out conditions that raise accident risk

These ranges do not replace clinical judgment. Someone with a lower score who still dozes off while driving needs attention just as much as a person with a higher score who feels unsafe. The questionnaire gives a starting point for that conversation, not the final word.

What Different Score Ranges Usually Mean

A low total can bring a sense of relief, especially when you have worried about a sleep disorder. A normal score does not rule out every problem, though. Pain, insomnia, and other conditions can leave you worn out while still leaving this total below 11. That is one reason doctors always pair the epstein sleepiness scale with questions about bedtime, waking, and how long it takes to fall asleep.

When A Higher Score Raises Concern

Scores of 11 or more point toward excessive daytime sleepiness in many guides. In that range, clinicians start to think about sleep apnea, narcolepsy, shift-work related disorders, medication side effects, and more. They will ask whether you snore loudly, gasp in your sleep, wake with headaches, or feel paralyzed when drifting off or waking up.

If your number reaches the mid-teens or above, especially if you doze during conversations or while driving, doctors often move quickly. They may arrange overnight monitoring, home sleep apnea testing, or other studies. The score gives them a way to track change after treatment as well. If your number drops by several points once therapy starts, that supports the sense that things are getting better.

When To Talk To A Doctor About Sleepiness

You do not need to wait for a perfect score sheet to speak with a professional. Any pattern of nodding off in risky situations calls for help. That includes dozing at the wheel, on machinery, or during tasks that need steady focus. It also includes persistent sleepiness that strains your mood, relationships, or job.

Warning Signs That Deserve Prompt Attention

Red flags include near-miss accidents on the road, friends or family members who notice you stop breathing at night, trouble staying awake in meetings, and a strong urge to nap many times a day. If these sound familiar, bring both your epstein sleepiness scale score and a clear description of your days to an appointment.

A clinician can then combine the questionnaire with a full history and, when needed, objective tests. The scale alone cannot tell which sleep disorder you might have, yet it does show that your daily life includes more sleepiness than most people report.

Tips To Fill Out The Scale Honestly

Because the questionnaire relies on self-report, the quality of the score rests on how you answer. A few small habits can make it more accurate. Many people find it helpful to fill it out at a time of day when they usually feel alert, so they do not over- or under-estimate based on a single tired moment.

Practical Steps Before You Mark Your Answers

One simple step is to keep a short sleep diary for a week. Note what time you go to bed, what time you wake up, naps, caffeine, and alcohol. Then, when you sit down with the questionnaire, think about that whole week instead of just last night. If you tend to nap every afternoon, for example, your rating for “lying down to rest in the afternoon” should show that habit.

If a friend or partner sees you doze in situations you do not remember, ask for their view as well. They might point out that your head often drops during movies or that you fall asleep during conversations more than you realize. Their memories can help you pick scores that match real life.

Using Your Score To Start A Conversation

Once you have your total, write it down with the date. If you later start treatment for a sleep disorder, you can refill the same questionnaire every month or two. Watching the number rise or fall over time gives both you and your clinician a simple way to track change in daytime sleepiness alongside other tests and visits.

Daytime dozing is not something you just have to “live with.” The epstein sleepiness scale offers a quick snapshot of how sleepy you really feel during regular life. Paired with professional care, that snapshot can be the first step toward safer driving, clearer thinking, and more energy for the parts of the day that matter most to you.