The Epworth Sleepiness Scale (ESS)
Dr Johns first developed the ESS for adults in 1990 and subsequently modified it slightly in 1997. He developed it so he could assess the ‘daytime sleepiness’ of the patients in his own private practice of Sleep Medicine. He named the questionnaire after Epworth Hospital in Melbourne, where he established the Epworth Sleep Centre in 1988.
The ESS is a self-administered questionnaire with 8 questions. Respondents are asked to rate, on a 4-point scale (0-3), their usual chances of dozing off or falling asleep while engaged in eight different activities. Most people engage in those activities at least occasionally, although not necessarily every day. The ESS score (the sum of 8 item scores, 0-3) can range from 0 to 24. The higher the ESS score, the higher that person’s average sleep propensity in daily life (ASP), or their ‘daytime sleepiness’. The questionnaire takes no more than 2 or 3 minutes to answer. It is available in many different languages.
The Berlin Questionnaire
The Berlin questionnaire screens for obstructive sleep apnea in idiopathic intracranial hypertension. The BQ incorporates questions about snoring (category 1), daytime somnolence (category 2), and hypertension and BMI (category 3). The BQ was administered at the time of the patient's initial visit. When available, the patient's family or bed partner was asked to confirm the accuracy of responses to the questions about snoring. The overall BQ score was determined, as in previous studies, from the responses to the three categories: scores from the first and second categories were positive if the responses indicated frequent symptoms (>3–4 times/week), whereas the score from the third category was positive if there was a history of hypertension or a BMI >30 kg/m2. Patients were scored as being at high-risk for OSA if they had a positive score on two or more categories, while those who did not were scored as being at low-risk.