The Epworth Sleepiness Scale asks how likely a person is to doze off in eight everyday situations. Each scores 0 to 3, and the total, from 0 to 24, shows how sleepy they usually are in the daytime: above 10 is excessive sleepiness. See what each score range means and what to check next, then record the result with the free template.
ESS result template
FreeEPWORTH SLEEPINESS SCALE RESULT Date: [Date] Patient: [Name or ID, age] Form: [Adult ESS or ESS-CHAD, language, from the licensed source] Completed: [By the patient alone, with help, or read aloud; interpreter if used] Reason: [Daytime sleepiness, snoring, suspected sleep apnea, treatment review, or work assessment] SCORE Total: [0 to 24, all eight items answered] Range: [Normal, mild, moderate, or severe excessive daytime sleepiness] Previous ESS: [Dates and totals, or first score] CONTEXT Sleep hours: [Usual bedtime and wake time, and hours slept on work and free days] Work pattern: [Day work, rotating shifts, nights, or long-haul driving] Medicines and substances: [Sedating medicines, opioids, antihistamines, alcohol, cannabis, and caffeine] Drowsy driving: [Dozing at the wheel, near misses, or crashes, and the license type] RELATED FINDINGS Breathing in sleep: [Snoring, witnessed apneas, choking or gasping, morning headaches] Examination: [BMI, neck size, blood pressure, and airway] Apnea risk: [STOP-Bang or other risk score, if used] Other causes considered: [Low mood, thyroid, restless legs, cataplexy, insomnia, or body clock problems] Impression: [Likely cause of the sleepiness, or still unclear] PLAN Next step: [Sleep study, sleep clinic referral, sleep hygiene, shift-work advice, medicine change, or treatment change] Driving advice: [What was advised, and any licensing requirement discussed] Teaching: [What the patient was told and understood] REPEAT Score again: [Date or interval, such as weeks after treatment starts] What would change the plan: [The score or new symptom that prompts referral or a change] Clinician: [Name, credentials]
Use it for
The patient completes it on their own, on the official form, rating how likely they are to doze in each situation in recent times: the last few weeks or months, not today.
Avoid: Explaining what the score means while the patient is still answering. The developer advises against it, as it can change the answers.
Each of the eight items scores 0 to 3; add them for a total from 0 to 24.
Avoid: Guessing or prorating a missing item. A form with a blank item gives no valid score; ask the item instead.
0 to 10 is the normal range, and 11 or more is excessive daytime sleepiness, rising in severity to 24.
Avoid: Reading a high score as a diagnosis. The ESS says how sleepy, not why; the history and, often, a sleep study find the cause.
A score above 10 starts the search for a cause; a sleep history usually narrows it.
Avoid: Stopping at “not enough sleep” when the patient sleeps 7 to 8 hours and is still sleepy. That pattern needs a sleep study.
Ask every sleepy patient about driving, whatever the total, and record what you advised.
Avoid: Letting a normal score settle the question. People with a normal total can still doze at the wheel, and the ESS alone shouldn’t decide licensing.
Repeat the ESS after a change in treatment, such as a few weeks after starting CPAP, to see whether sleepiness has eased.
Each one follows the recording template. Use them to judge how much to write.
Family practice, blood pressure follow-up, form completed in the waiting room
Total 16, severe excessive daytime sleepiness. All eight items answered. First ESS.
49-year-old long-haul truck driver. Sleeps about 6 hours a night in his cab on work nights, 8 on days off. No sedating medicines; 3 to 4 coffees a day, 2 beers on weekends. Dozed at the wheel last month and woke on the rumble strip; no crashes.
Loud snoring every night for years; his wife has seen him stop breathing and gasp. Morning headaches. BMI 34, neck 45 cm (17.7 in), blood pressure 148/92 on two medicines. STOP-Bang 6, high risk. Mood good, no cataplexy, no restless legs. Impression: likely obstructive sleep apnea.
Referred for a sleep study, marked urgent because of his work and the near miss. Advised not to drive any vehicle while drowsy, and to stop commercial driving until he is assessed and treated; he will speak with his employer. Licensing requirements for his license class discussed and recorded. Weight and alcohol advice given.
ESS again 4 to 6 weeks after treatment starts, with CPAP use data if it’s prescribed. Aim: 10 or below, with good CPAP use, before he goes back to long-haul driving, alongside any licensing requirement.
Occupational health clinic, staff wellness referral
Total 12, mild excessive daytime sleepiness. All eight items answered. First ESS.
34-year-old ICU nurse working three 12-hour night shifts a week. Sleeps 4 to 5 hours after a night shift, in a bright, noisy bedroom; 7 hours on days off. Takes diphenhydramine 50 mg to sleep after some shifts, and an energy drink at 3 a.m. Nodded off at a red light driving home twice this month.
No snoring or witnessed apneas, says her partner. BMI 23, neck 33 cm (13 in). No cataplexy, no restless legs, mood good. Impression: sleepiness from short day sleep on night shifts, made worse by the antihistamine.
Shift-work sleep advice: a blackout blind, earplugs, and a protected 7-hour sleep window after nights; a 20-minute nap before each shift; caffeine only in the first half of the shift; sunglasses for the drive home. Stop diphenhydramine. Not to drive home drowsy: nap first or get a ride. Letter for her manager supporting fewer back-to-back nights.
ESS again at a 6-week review. If still 11 or more with 7 hours of day sleep, or if snoring or other symptoms appear, refer for a sleep study. Review at 6 weeks, by telehealth: ESS 7, normal range. Sleeping 6.5 to 7 hours after nights, off diphenhydramine, no drowsy drives. Plan continued; score again if her rota changes.
Many people with significant apnea score 10 or below. Snoring with witnessed apneas, a large neck, or resistant high blood pressure still needs assessing.
A total of 15 says the patient is very sleepy, not why. Take the sleep history before deciding between a sleep study, a medicine change, or sleep advice.
A missing item makes the ESS invalid, and prorating it isn’t accepted. Check the form while the patient is still there.
Retyped and reworded versions circulate online, and they aren’t validated. Use the licensed form and its official translations.
A sleepy patient who drives needs to be asked about dozing at the wheel and given clear advice, recorded in the note, whatever the total.
Vero Scribe records the ESS result in your template from the visit, with the patient’s consent, or from your dictation: the total, the context, the findings that point to a cause, and the driving advice you gave. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
The patient rates how likely they are to doze off in each of eight everyday situations, from 0 for no chance to 3 for a high chance. Add the eight scores for a total from 0 to 24. Round a half-point total up, and treat a form with a missing item as invalid.
0 to 10 is the normal range. The developer splits it into 0 to 5, lower normal, and 6 to 10, higher normal daytime sleepiness. Above 10 is excessive daytime sleepiness: 11 to 12 mild, 13 to 15 moderate, and 16 to 24 severe.
None on its own. The ESS measures sleepiness, and many people with moderate or severe sleep apnea score in the normal range. A score above 10, with snoring, witnessed apneas, or a high apnea risk score, points toward a sleep study, which makes the diagnosis.
The ESS measures how sleepy someone is, whatever the cause. STOP-Bang estimates how likely obstructive sleep apnea is, from eight yes-or-no items on snoring, tiredness, observed apneas, blood pressure, BMI, age, neck size, and sex; 5 or more of 8 is high risk. They answer different questions, and many clinics use both.
Each describes an everyday situation, most of them sitting, chosen because they differ in how strongly they tend to make people doze. The official form, with its exact wording and translations, comes from Mapi Research Trust’s ePROVIDE site. Use that form rather than a copy found online, as altered versions aren’t validated.
The patient completes it themselves, in a few minutes, in the waiting room, online, or at home. Any member of the care team can hand it out and score it, and the clinician reads it alongside the history. It can be read aloud word for word when reading is hard.
Not on its own. The developer advises against using the ESS alone for decisions such as granting or withholding a license, as it can’t predict drowsiness at a given moment. Ask about dozing at the wheel and near misses, advise against drowsy driving, and follow the licensing rules where the patient lives.
Studies in sleep apnea treated with CPAP put the smallest improvement patients notice at 2 to 3 points. The aim is a score in the normal range. If it stays above 10 on treatment, check CPAP use and sleep hours, then look for a second cause.
Use the ESS-CHAD, the authorized version for children and adolescents published in 2015. It is scored the same way, from 0 to 24. Most children from about 9 can answer it alone; younger children need a parent’s help.
For students, individual clinicians, clinical practice, and unfunded academic research, yes: download the official form and its translations free from Mapi Research Trust’s ePROVIDE site after signing up. Funded research, healthcare organizations, and commercial users need a license agreement, and fees may apply; so does any electronic version, such as one built into an app. The recording template on this page is free to copy or download.
Eight yes-or-no criteria for obstructive sleep apnea risk, before surgery and in clinic: scored 0 to 8, with 5 or more high risk.
For the study that follows a high score: AHI, oxygen levels, and the treatment plan.
Sleep clinic visits, study results, and CPAP follow-up in one place.
Respiratory visits, testing, and patient plans.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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