Are you suffering from excessive daytime sleepiness?

This scientific test can measure the level of your daytime sleepiness and detect if you have sleep apnea or narcolepsy.

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Executive Summary

If you feel excessively sleepy during daytime, you are not getting sufficient sleep. Having inadequate sleep can lead to serious medical problems and occupational hazards.

Find out your degree of daytime sleepiness, or Epworth Sleepiness Score. If your ESS score is between 11 and 24, seek professional, medical help.

The full article explains how to measure your degree of daytime sleepiness.

Sleep is an essential part of life. In spite of years of research, no one has found out how to substitute sleep with anything else. Neither does anyone know if any dietary habits or supplements will reduce the need for sleep. In other words, the amount of sleep your body needs is perhaps, not changeable and not even short-changeable.

If you are suffering from excessive daytime sleepiness, you are not getting sufficient sleep. There are serious medical consequences of having inadequate sleep.

Read on this website: Short sleep duration can increase your chances of heart attack.

To understand the risk better, it is a good idea to judge, or even better, measure the daytime sleepiness. Ideally, if you are getting sufficient sleep in the night, you should not get any daytime sleepiness. So a measure of your daytime sleepiness will point to the potential health risks.

How to measure daytime sleepiness

Dr Murray Johns of Epworth Hospital, Melbourne, Australia devised a simple questionnaire to calculate the level of daytime sleepiness. It is called Epworth Sleepiness Test. The test asks one the chances of one’s sleeping, or dozing, during 8 normal daytime situations. The person assigns a number from 0 to 3, based on the chance of his falling asleep during that situation. The rating scale is:

  • 0 = no chance of falling asleep
  • 1 = slight chance of falling asleep
  • 2 = moderate chance of falling asleep
  • 3 = high chance of falling asleep

The sum total of these points is called the Epworth Sleepiness Score (ESS).

The eight activities are:

  1. Sitting and reading
  2. Watching TV
  3. Sitting inactive in a public place (such as a theatre, or a meeting)
  4. As a passenger in a car for an hour without a break
  5. Lying down to rest in the afternoon when circumstances permit
  6. Sitting and talking to someone
  7. Sitting quietly after a lunch (but without alcohol)
  8. In a car, while stopped for a few minutes in the traffic

Thus, your daytime sleepiness score can be from 0 to 24.

Technical Information

This ESS test has been found to be useful in predicting Obstructive Sleep Apnea, Narcolepsy and Idiopathic Hypersomnia.

The quality of a test is decided by its sensitivity as well as specificity.

Sensitivity of a test is defined as the ability of a test to correctly identify those with the disease (for which the test is performed). This is also known as True Positive Rate: if there are 100 actual patients (but we don’t know that yet) and we perform our test on them, how many of them will be correctly flagged as patients by the test?

The ESS test has a high sensitivity of 93.5% in detecting Narcolepsy. A test that is low on sensitivity will miss out many patients who are having the disease; the test will wrongly call them disease-free and the patient might suffer later, if the disease stays untreated, and becomes more severe. The ESS test will nearly not miss detecting a narcoleptic patient.

Specificity of a test is defined as the ability of a test to correctly identify those without the disease (for which the test is performed). This is also known as True Negative Rate: if there are 100 people who are not patients (but we don’t know that yet) and we perform our test on them, how many of them will be correctly flagged as disease-free by the test?

The ESS test has a perfect specificity of 100% in detecting Narcolepsy. A test that is low on specificity will flag too many normal people as patients, needing unnecessary treatment to the person, along with its financial and emotional costs. The ESS test will not misdiagnose any normal person as narcoleptic.

Interpretation of the daytime sleepiness test scores

If the score is from 0 to 10, it is considered normal. If the score is between 11 and 24, it indicates excessive sleepiness and you are advised to seek medical, professional help.

Scores between 11-15 may be indicative of mild to moderate sleep apnea, while scores ranging in 16-24 may suggest severe sleep apnea or narcolepsy, which is an extreme tendency to fall asleep in a relaxing situation, such as sitting quietly.

Other signs of lack of sleep

There are many other subtle signs that tell you that you may not be getting adequate sleep. They are less common and easy to miss.

Read this article on this website: 14 subtle signs of sleep deprivation that you may miss.

Actionable tips

  1. Measure your degree of daytime sleepiness, or Epworth Sleepiness Score.
    Click here for an online ESS calculator: Interactive Epworth Sleepiness Score Calculator.
  2. If the score is 11–15, sleep extra for a few long hours for some days.
    Check the score once again after a few days. Repeat this point till the score comes below 11.
  3. If the score is 16–20, consider seeking medical help.
    Try to avoid operating any critical equipment or machinery. Avoid long driving or long commutes.
  4. If the score is above 20, seek medical help.
    Avoid operating any critical equipment, machinery, or taking critical business decisions. Avoid driving at all costs.

First Published on: 5th August, 2010

Image credit: bruce mars on Pexels.com

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