The use of an online pictorial Epworth Sleepiness Scale in the assessment of age and gender specific differences in excessive daytime sleepiness

Panagis Drakatos, Ramesh Ghiassi, Ian Jarrold, Judy Harris, Athar Abidi, Abdel Douiri, Nicholas Hart, Christopher Kosky, Adrian J. Williams, Martyn R. Partridge, Joerg Steier


Background: Excessive daytime sleepiness (EDS) is a non-specific but highly prevalent cardinal symptom of sleep disorders. We hypothesized that with modern media and an online pictorial Epworth Sleepiness Scale (ESS) age and gender specific differences of EDS could be identified on a large scale. This could be helpful in the screening of patients with sleep disorders.
Patients and methods: In 8,098 subjects, age and gender were recorded in addition to an online pictorial ESS (range 0-24 points). The cut-off for EDS (ESS >10 points) was chosen in line with the traditional ESS.
Results: The prevalence of EDS was slightly higher in male subjects (45% vs. 43%, P=0.033). When age was considered, female subjects tended to be sleepier in their 3rd and 4th lifetime decade (P=0.01 and P=0.003, respectively), whilst male subjects scored significantly higher in their 7th decade (P<0.0001); there was a trend to more daytime symptoms with higher age (P for trend <0.001).
Conclusions: The online pictorial ESS identifies gender differences in EDS and reveals increased levels of sleepiness associated with higher age. The use of modern media facilitates reaching out to the general population to raise awareness of conditions associated with EDS such as sleep apnoea.