Epworth Sleepiness Scale

The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy. If you score 10 or more on this test, you should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and/or need to see a sleep specialist. These issues should be discussed with your personal physician.

 

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

 

0 = would never doze or sleep.

1 = slight chance of dozing or sleeping

2 = moderate chance of dozing or sleeping

3 = high chance of dozing or sleeping

Excessive Daytime Sleepiness

 

Excessive Daytime Sleepiness (EDS) is a condition in which an individual feels very drowsy during the day and has an overwhelming urge to fall asleep, even after getting enough nighttime sleep. People with EDS frequently doze, nap, or fall asleep in situations where they need or want to be fully awake and alert. This can be particularly dangerous at times, such as when driving a car or operating other hazardous machinery.

 

EDS can interfere significantly with a person's ability to concentrate and perform daily tasks and routines. People with EDS often report feelings of low self-esteem, frustration, and anger about being is understood and regarded as unintelligent, lazy or uninterested in learning. They also report having difficulty with relationships -- in social situations, in the workplace, and within the family.

 

EDS is a sign of an underlying medical condition, typically a sleep disorder.

 

The following sleep disorders are often associated with

excessive daytime sleepiness:

 

Narcolepsy

Sleep Apnea

Periodic Leg Movements in Sleep (PLMS)

Restless Legs Syndrome (RLS)

Circadian Rhythm Disorder

 

 

Narcolepsy

 

 

Narcolepsy is a chronic neurological disorder that affects the region of the central nervous system that regulates sleep and wakefulness. Symptoms of narcolepsy generally appear in the second decade of life. It affects an estimated 200,000 Americans and is characterized by the following signs and symptoms:*

 

Sudden, uncontrollable episodes of sleep at inappropriate times, such as while having dinner, talking, driving or working Sudden episodes of loss of muscle tone, ranging from slight weakness (such as limpness at the neck or knees, sagging facial muscles, or inability to speak clearly) to complete body collapse (This can be precipitated by intense emotion, such as laughter or anger.) Inability to talk or move when falling asleep or waking up Vivid, often unpleasant, dream-like experiences that occur while dozing or falling asleep disrupted nighttime sleep with frequent awakenings performance of routine tasks without memory of the action learning and memory difficulties.

 

* Not all individuals with narcolepsy experience every sign or

symptom.

 

 

Sleep Apnea

 

 

Sleep apnea is a serious, potentially life-threatening breathing disorder which affects 6 million adult  Americans. Some studies indicate that it is associated with an increased risk of heart attack and stroke. More common in men than women, apnea is experienced by sufferers as a lack of air flow throughout the

night. This leads to frequent brief arousals. Sleep apnea occurs in four percent of middle-aged men and two percent of middle-aged women. Over age 65, the prevalence rises to 28 percent and 24 percent for men and women respectively. Sleep apnea is characterized by the following signs and symptoms:

 

Brief interruptions of air flow during sleep and loss of oxygen

Repetitive arousals, often unnoticed, during sleep

Falling asleep at inappropriate times during the day, such as

while driving, working or talking

Early morning headaches

Depression, irritability and sexual dysfunction

Learning and memory difficulties

 

 

 

 

Periodic Leg Movements

 

 

Periodic leg movements in sleep (PLMS) is a syndrome that consists of periodic movements of the legs, feet, and/or toes during sleep. People with PLMS are often not aware of these movements, and often complain of several symptoms, including:

 

Insomnia

 

Excessive daytime sleepiness

 

Frequent awakenings from sleep, or

 

Unrefreshing sleep

 

 

 

Restless Leg Syndrome (RLS)

 

 

Restless legs syndrome (RLS) is marked by uncomfortable leg sensations that occur continually while the body is at rest. It may be a central nervous system disorder and occasionally is associated with iron-deficiency anemia, pregnancy or diabetes. RLS is the basic cause of sleep deprivation for up to an

estimated 4 million adult Americans. RLS is characterized by the following signs and symptoms:

 

The urge to move the legs, which is often accompanied by uncomfortable sensations in the foot, calf or upper leg (These sensations are usually described as a creeping or crawling feeling and may sometimes be experienced as a tingling, cramping or burning sensation.)

 

The need to move the legs to relieve the discomfort by stretching, bending or rubbing the legs, tossing or turning in bed, or getting up and pacing the floor A worsening of discomfort when lying down, especially when trying to fall asleep at night a tendency to experience the most discomfort late in the day and at night

continuous nighttime sleep disruption daytime fatigue

 

 

 

Circadian Rhythm Disruption

 

 

More than 25 million Americans have non-traditional work schedules, and many of these individuals have difficulty sleeping during the day and staying alert on the job at night. Shift  workers' struggles are biologically based: Their sleep and work schedules conflict with their biological clocks. The biological

clock or circadian rhythm is the fluctuation of sleep-wake states. This fluctuation is generally linked to the 24-hour, daily dark-light cycle. Shift workers attempt to sleep when their bodies tell them to be awake, which often results in chronic sleep loss. Shift workers are more likely than people who keep "traditional"

work schedules to experience:

 

Memory and concentration difficulties and impaired job

performance

Stomach problems (especially heartburn and indigestion)

Menstrual irregularities

Colds and flu

Weight gain

High blood pressure and heart problems

Workplace and automobile accidents

 

Center for Headaches, TMJ & Sleep Disorders

Steven J Wilk, DDS

 

303-758-4865