8-item questionnaire measuring daytime sleepiness in everyday situations. ≈ 2 min to complete. Free with attribution.
ESS (Epworth Sleepiness Scale) is a validated clinical instrument used to assess 8-item questionnaire measuring daytime sleepiness in everyday situations.. It is most often used for 8-item questionnaire measuring daytime sleepiness in everyday situations.. The instrument contains 8 items. Typical administration time is ≈ 2 min.
Source / attribution: Free to use with citation
8-item questionnaire measuring daytime sleepiness in everyday situations. ESS is part of standard practice in this setting because it provides a structured, replicable assessment that can be tracked over time and compared across patients or visits.
Like all screening or assessment instruments, ESS is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 8 items below to see your ESS score and interpretation.
Each item is scored on a 4-point scale (0–3). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
Sum all 8 items scored 0-3. Total range 0-24. Score > 10 indicates abnormal sleepiness.
Scoring notes: Sum all 8 items scored 0-3. Total range 0-24. Score > 10 indicates abnormal sleepiness.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–10 | Normal daytime sleepiness | None |
| 11–15 | Mild sleepiness | Monitor |
| 16–24 | Severe sleepiness | Refer to sleep specialist |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | Sitting and reading | Moderate chance of dozing | 2 |
| 2 | Watching TV | Moderate chance of dozing | 2 |
| 3 | Sitting, inactive in a public place (e.g., a theatre or a meeting) | Slight chance of dozing | 1 |
| 4 | As a passenger in a car for an hour without a break | Moderate chance of dozing | 2 |
| 5 | Lying down to rest in the afternoon when circumstances permit | Slight chance of dozing | 1 |
| 6 | Sitting and talking to someone | Moderate chance of dozing | 2 |
| 7 | Sitting quietly after a lunch without alcohol | Slight chance of dozing | 1 |
| 8 | In a car, while stopped for a few minutes in traffic | Moderate chance of dozing | 2 |
Add up all the item scores you noted in Step 1.
2 + 2 + 1 + 2 + 1 + 2 + 1 + 2 = 13
Find the row in the interpretation table whose range contains your total:
Total = 13 falls between 11 and 15 → Mild sleepiness
Mild sleepiness. Monitor
A score is one input alongside history and examination. ESS supports clinical judgment — it does not replace it.
Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.
If ESS doesn't fit your context, related instruments in sleep include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| ISI | Brief screening measure for insomnia severity and outcomes. | 7 | ≈ 2 min |
| PSQI | 19-item measure assessing sleep quality and disturbances over one month. | 7 | ≈ 5 min |
| AIS | 8-item scale based on ICD-10 insomnia criteria for clinical assessment. | 8 | ≈ 2 min |
| PHQ-9 | Severity of depression | 9 | ≈ 3 minutes |
| GAD-7 | Severity of generalized anxiety | 7 | ≈ 2 minutes |
| AUDIT | 10-item WHO screening tool for hazardous alcohol consumption and dependence. | 10 | ≈ 3 min |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
| Glasgow Coma Scale | Level of consciousness after head injury | 3 | — |
ESS (Epworth Sleepiness Scale) is a validated instrument that assesses daytime sleepiness in everyday situations. It is designed for clinicians, medical students, evidence-synthesis researchers. It takes about 2 min to complete, and the 8 items are summed to produce a total score.
ESS typically takes about 2 min to administer. The exact duration varies a little depending on whether it is self-administered or completed with a clinician. Its brief format is part of what makes it practical for routine clinical use and for repeat administration when tracking change over time.
ESS contains 8 items. Item scores are summed to produce the total. Scores run from 0 to 24, grouped into 3 interpretation bands from ‘Normal daytime sleepiness’ up to ‘Severe sleepiness’.
On the ESS (total score 0–24), scores of 16–24 fall in the ‘Severe sleepiness’ band — interpreted as: Refer to sleep specialist. The full ladder is: 0–10 — Normal daytime sleepiness: None.; 11–15 — Mild sleepiness: Monitor.; 16–24 — Severe sleepiness: Refer to sleep specialist. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–10 fall in the ‘Normal daytime sleepiness’ band: None. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
ESS has reported Cronbach's α of 0.88 in validation samples and test–retest reliability of 0.86. Predicts sleep apnea and other sleep disorders. In practical terms, a Cronbach’s α around 0.88 indicates good internal consistency (the items hang together well), and a test–retest reliability of 0.86 means scores are strongly stable when the scale is repeated without real clinical change.
ESS is free to use with attribution — clinical, educational, and research use is permitted provided the original source is credited. If you publish results or reproduce the scale, include the citation to the source paper.
Johns, M. W. (1991). A new method for measuring daytime sleepiness. Sleep, 14(6), 540-545. This is the original publication for the ESS — the reference to cite when reporting results.
No. ESS is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of daytime sleepiness in everyday situations — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
ESS is supported by the following peer-reviewed sources: