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SYMPTOM SCREENERS:

MEASURING SLEEPINESS

|

EXPLORING SYMPTOMS

Measuring Daytime Sleepiness in Adults

Epworth Sleepiness Scale (ESS)

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Complete this and share your results with your healthcare provider.

Use the following scale to choose the most appropriate number for each situation.

It is important that you answer each item as best as you can.

Situation

Chance of Dozing

Situation/
Chance of Dozing

No chance
of dozing

Slight chance
of dozing

Moderate chance
of dozing

High chance
of dozing

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

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Watching TV 2 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting inactive in a public place (e.g., a theater or a meeting) 3 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

As a passenger in a car for an hour without a break 4 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Lying down to rest in the afternoon while circumstances permit 5 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting and talking to someone 6 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting quietly after a lunch without alcohol 7 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

In a car or bus, while stopped for a few minutes in traffic 8 of 8

No chance of dozing

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Higher scores are associated with more daytime sleepiness. You should discuss your responses and your score with your healthcare provider.

Total Score = 0

ESS © MW Johns 1990-1997. Used under License

For any information on the distribution rights for the ESS, please contact Mapi Research Trust, Lyon, France, Internet: https://eprovide.mapi-trust.org

Exploring Symptoms in Adults

Swiss Narcolepsy Scale (SNS)

The SNS assesses the frequency of 5 symptoms that can be used to screen for the presence of narcolepsy with cataplexy. Complete this and share your results with your healthcare provider.

Please choose the best answers using the scales shown for each question.

Interactive Scale

Never

Rarely
(Less than once a month)

Sometimes
(1-3 times a month)

Often
(1-2 times a week)

Almost
always

How often are you unable to fall asleep?
How often do you feel bad or not well
rested in the morning?

Never

I would like to, but cannot

1-2 times a week

3-5 times a week

Almost daily

How often do you take a nap during
the day?

Never

Rarely
(Less than once a month)

Sometimes
(1-3 times a month)

Often
(1-2 times a week)

Almost
always

How often have you experienced weak
knees/buckling of the knees during
emotions like laughing, happiness,
or anger?
How often have you experienced sagging
of the jaw during emotions like laughing,
happiness, or anger?
How often are you unable to fall asleep? 1 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost always

How often do you feel bad or not well
rested in the morning? 2 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost always

How often do you take a nap during
the day? 3 of 5

Never

I would like to, but cannot

1-2 times a week

3-5 times a week

Almost daily

How often have you experienced weak
knees/buckling of the knees during
emotions like laughing, happiness,
or anger? 4 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost always

How often have you experienced sagging
of the jaw during emotions like laughing,
happiness, or anger? 5 of 5

Never

Rarely (Less than once a month)

Sometimes (1-3 times a month)

Often (1-2 times a week)

Almost always

Negative scores are suggestive of narcolepsy with cataplexy.

Total Score = 0

This copyrighted material is reproduced with the permission of the authors. Unauthorized copy, printing, or distribution is strictly prohibited.

Sources: Bassetti CL. Spectrum of narcolepsy. In: Baumann CR, Bassetti CL, Scammell TE, eds. Narcolepsy: Pathophysiology, Diagnosis, and Treatment. New York, NY: Springer Science+Business Media, LLC; 2011:309-319. Sturzenegger C, Bassetti CL. The clinical spectrum of narcolepsy with cataplexy: a reappraisal. J Sleep Res. 2004;13(4):395-406. Sturzenegger C, Baumann CR, Kallweit U, Lammers GJ, Bassetti CL. Swiss Narcolepsy Scale: a valid tool for the identification of hypocretin-1 deficient patients with narcolepsy. J Sleep Res. 2014;23(suppl 1):297.

Your next step

You likely completed a screener because you experience at least 1 symptom of narcolepsy. While the screeners provide useful information about your symptoms, they cannot determine whether you have narcolepsy. Your next step should be seeing a sleep specialist. Share your scores and work with the sleep specialist to decide what you should do next.

Discuss your scores with a sleep specialist, who can determine whether you should undergo narcolepsy testing.

Find a sleep specialist near you