Normative values of the Epworth Sleepiness Scale (ESS), derived from a large German sample
Daytime sleepiness is associated with several medical problems. The aim of this paper is to provide normative values for one of the most often used questionnaires measuring daytime sleepiness, the Epworth Sleepiness Scale (ESS).
A large sample of 9711 people from the German general population took part in this study. In addition to the ESS, several other questionnaires were used, and sociodemographic and behavioral factors were recorded.
Normative values for the ESS are given. According to the generally accepted criterion ESS > 10, 23 % of the sample showed excessive daytime sleepiness. Males reported significantly more daytime sleepiness than females (effect size d = 0.19). In the age range of 40–80 years, a continuous decline of daytime sleepiness was observed. Psychometric properties of the ESS were good. Alcohol intake and nicotine consumption were marginally associated with daytime sleepiness, and obese people reported significantly more sleepiness than people of normal weight (OR = 1.39).
The normative tables allow clinicians and researchers to assess the degree of their patients’ daytime sleepiness, especially in the upper range of scores.
KeywordsDaytime sleepiness Epidemiology Normative values Prognostic factors Population-based study
This paper is supported by LIFE, Leipzig Research Centre for Civilization Diseases, an organizational unit affiliated to the Medical faculty of the University of Leipzig. LIFE is funded by means of the European Union, by the European Regional Development Fund (ERDF), and by funds of the Free State of Saxony within the excellence initiative (project numbers 713–241202, 14505/2470, 14575/2470).
Compliance with ethical standards
This study was funded by the European Regional Development Fund (ERDF) and by funds of the Free State of Saxony within the excellence initiative (project numbers 713–241202, 14505/2470, 14575/2470). The sponsors had no role in the design or conduct of this research.
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.American Academy of Sleep Medicine (2014) International classification of sleep disorders: diagnostic and coding manual, third edition (ICSD-3)Google Scholar
- 5.Leger D, Bayon V, Ohayon MM, Philip P, Ement P, Metlaine A, Chennaoui M, Faraut B (2014) Insomnia and accidents: cross-sectional study (EQUINOX) on sleep-related home, work and car accidents in 5293 subjects with insomnia from 10 countries. J Sleep Res 23:143–152Google Scholar
- 27.Scalarum CIP (ed) (2005) Internationale Skalen für Psychiatrie, 5th edn. Beltz, GöttingenGoogle Scholar
- 28.Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) http://www.dgsm.de/fachinformationen_frageboegen_epworth.php?language=german Accessed 20 Apr 2016
- 30.Ware JE, Kosinski M, Dewey JE, Gandek B (2001) How to score and interpret single-item health status measures: a manual for users of the SF-8TM Health Survey. Lincoln (RI), QualityMetric IncorporatedGoogle Scholar