The Epworth Sleepiness Scale: A Simple Tool to Check Daytime Sleepiness

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What is the Epworth Sleepiness Scale (ESS)?

The Epworth Sleepiness Scale (ESS) is a short questionnaire that estimates how likely someone is to fall asleep during daily activities. It can indicate daytime sleepiness and help healthcare providers diagnose conditions like sleep apnea, insomnia, or other sleep-related issues. It is also simple, only taking a few minutes and not needing any preparation.

Everyday Scenarios the ESS Can Look At

Instead of testing memory or problem-solving, the ESS focuses on the experience of being tired during the day. You score yourself (0–3) on how likely you are to doze off while:

• Reading or watching TV

• Sitting quietly in class or a meeting

• Riding in a car as a passenger

• Having a conversation or waiting at a stoplight

• Resting in the afternoon or lying down

The total score ranges from 0 to 24, with higher numbers suggesting more sleepiness.

How You Actually Take the Test

The ESS is self-reported, meaning you fill it out on your own. You read each situation, choose a number that fits how sleepy you’d be, and add the points. A healthcare provider may then discuss patterns or any cause of concern from your answers. 

Interpreting Your Score

Here’s how most healthcare providers view ESS results:

Score	What It Suggests
0–10	Within normal limits
11–12	Slightly more sleepy than expected
13–15	Noticeable sleepiness; worth discussing
16–24	Concerning level of sleepiness; further testing recommended

This score isn’t a diagnosis but rather a starting point. It helps guide decisions about next steps, especially if symptoms interfere with daily life.

What Can Influence a High Score

Not all sleepiness is due to a medical condition. Other factors that may raise your score include:

• Shift work, late-night schedules

• Stress, anxiety, or burnout

• Untreated medical conditions or medications

• Poor sleep routines or inconsistent bedtimes

A healthcare provider can consider these alongside your results.

When You Should Bring This Up With a Doctor

Consider mentioning the ESS if you (or someone close to you) notices:

• Dozing off unintentionally

• Snoring loudly or gasping during sleep

• Waking up unrefreshed, even after a “full night”

• Difficulty concentrating, driving, or staying alert

The ESS may be repeated over time to track progress or treatment.

Small Habits That Support Better Sleep

While results guide the medical side, habits can help improve your lifestyle:

• Keep a steady sleep-wake routine

• Limit caffeine late in the day

• Create a darker, quieter sleep space

• Reduce screens before bed

• Ask about sleep studies if symptoms persist

With the right support, treatment, and healthy habits, better sleep is possible. The ESS is one of several tools to help you and your healthcare provider decide the next steps.

References 

“About the ESS.” Epworth Sleepiness Scale, epworthsleepinessscale.com/about-the-ess/. Accessed 24 Dec. 2025. 

“Epworth Sleepiness Scale.” Sleep Medicine, sleep.hms.harvard.edu/epworth-sleepiness-scale. Accessed 24 Dec. 2025. 

“What Is the Epworth Sleepiness Scale?” Cleveland Clinic, 19 May 2025, my.clevelandclinic.org/health/diagnostics/epworth-sleepiness-scale-ess. 

Balachandran, D. “13 Healthy Sleep Habits.” MD Anderson Cancer Center, www.mdanderson.org/cancerwise/healthy-sleep-habits.h00-159778812.html. Accessed 28 Dec. 2025. 

Johns, M W. “Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale.” Chest vol. 103,1 (1993): 30-6. doi:10.1378/chest.103.1.30

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