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I'm a PatientMEASURING SLEEPINESS
EXPLORING SYMPTOMS
Screening for Narcolepsy Is Important
During appointments, ask your patients to complete the Epworth Sleepiness Scale (ESS) and/or the Swiss Narcolepsy Scale (SNS) and use the results to help guide your discussion.1,2
AASM, American Academy of Sleep Medicine.
Measure Your Patient’s Sleepiness
Epworth Sleepiness Scale1
How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired? This refers to your usual way of life recently. Even if you haven’t done some of these things recently try to work out how they would have affected you.
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.
No chance of Dozing
Slight Chance of Dozing
Moderate Chance of Dozing
High Chance of Dozing
Sitting and reading
1 of 8
Watching TV
2 of 8
Sitting inactive in a public place (e.g., a theatre or a meeting)
3 of 8
As a passenger in a car for an hour without a break
4 of 8
Lying down to rest in the afternoon while circumstances permit
5 of 8
Sitting and talking to someone
6 of 8
Sitting quietly after a lunch without alcohol
7 of 8
In a car or bus, while stopped for a few minutes in traffic
8 of 8
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
Explore Your Patient’s Symptoms
This tool was created to screen individuals for narcolepsy with cataplexy. Ask your patient to answer these questions.
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?
1 of 5
How often do you feel bad or not well rested in the morning?
2 of 5
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?
3 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 weak knees/buckling of the knees during emotions like laughing, happiness, or anger?
4 of 5
How often have you experienced sagging of the jaw during emotions like laughing, happiness, or anger?
5 of 5
This copyrighted material is reproduced with permission of the authors. Unauthorized copying, printing, or distribution is strictly prohibited.
*These screening tools are not intended to make a narcolepsy diagnosis or replace complete evaluation by a sleep specialist.
The content on this site is not meant to replace a conversation with a sleep specialist. A sleep specialist can evaluate for symptoms and make a diagnosis. A narcolepsy diagnosis should be established with a clinical interview and nighttime polysomnography (PSG) followed by a multiple sleep latency test (MSLT).7
- Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
- Sturzenegger C, Bassetti CL. The clinical spectrum of narcolepsy with cataplexy: a reappraisal. J Sleep Res. 2004;13(4):395-406.
- Krahn LE, Hershner S, Loeding LD, et al. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med. 2015;11(3):335-355.
- Johns M, Hocking B. Excessive daytime sleepiness: daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20(10):844-849.
- 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.
- 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; 2011:309-319.
- American Academy of Sleep Medicine. Central disorders of hypersomnolence. In: The International Classification of Sleep Disorders – Third Edition (ICSD-3) Online Version. Darien, IL: American Academy of Sleep Medicine; 2014.