From the Guidelines
The Epworth Sleepiness Scale (ESS) score of 5 indicates normal daytime sleepiness levels, and no intervention is required. This score falls within the normal range of 0-10, suggesting you do not have excessive daytime sleepiness, as supported by the guidelines outlined in the white paper by the American Gastroenterological Association 1. The ESS measures subjective sleepiness by asking how likely you are to doze off in eight different situations, with each scored 0-3, for a total possible score of 0-24. A score of 5 indicates you occasionally feel sleepy in some sedentary situations but maintain normal alertness for most activities. This is consistent with healthy sleep patterns and adequate sleep quality. Some key points to consider when interpreting the ESS score include:
- The scale is subjective and may not accurately reflect sleepiness in all individuals
- A score of 5 or less is generally considered normal, while scores above 10 may indicate excessive daytime sleepiness
- The ESS is just one tool used to evaluate sleepiness and should be considered in conjunction with other factors, such as medical history and lifestyle habits. While no treatment is needed for this score, maintaining good sleep hygiene practices is still beneficial, including:
- Keeping a regular sleep schedule
- Avoiding caffeine and alcohol before bedtime
- Creating a comfortable sleep environment
- Limiting screen time before sleep. If you experience other sleep-related symptoms despite this normal ESS score, consider consulting a healthcare provider for further evaluation, as they can provide personalized guidance and support to address any underlying concerns 1.
From the Research
Epworth Sleepiness Scale
- The Epworth Sleepiness Scale (ESS) is a widely used tool to measure sleepiness, with scores ranging from 0 to 24 2.
- A score of 5 or less is generally considered to be in the normal range, while a score of 11 or more indicates excessive daytime sleepiness 2.
- Studies have shown that modafinil can improve ESS scores in patients with obstructive sleep apnea (OSA) and excessive daytime sleepiness [(3,4,5)].
Treatment of Excessive Daytime Sleepiness
- Modafinil has been shown to be effective in reducing excessive daytime sleepiness in patients with OSA, with or without continuous positive airway pressure (CPAP) treatment [(3,4,5)].
- Armodafinil, a R-enantiomer of modafinil, has also been shown to improve ESS scores and reduce excessive daytime sleepiness in patients with OSA 4.
- The use of modafinil and armodafinil as adjunct therapies to CPAP treatment can improve wakefulness and reduce excessive daytime sleepiness in patients with OSA [(3,4)].
Clinical Utility of the Epworth Sleepiness Scale
- The ESS has been validated as a measure of sleepiness, but individual scores can vary considerably within patients 2.
- Classifying ESS scores as either normal or sleepy can improve the test-retest reliability of the scale 2.
- The ESS can be a useful tool in clinical practice to assess excessive daytime sleepiness and monitor treatment response in patients with OSA [(2,3,4,5)].