An ESS score >10 suggests excessive daytime sleepiness (EDS). An ESS score ≥16 suggests a high level of EDS. Scores within this range are generally associated with significant sleep disorders, including narcolepsy. A high ESS score is suggestive of EDS only and is not diagnostic for a specific sleep disorder.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines narcolepsy as recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. These must have been occurring at least three times per week over the past 3 months.
Epworth sleepiness scale
A score of 10 or below means you have the same level of daytime sleepiness as the general population. If you score 11 or above, you have an increased level of daytime sleepiness. If this is the case, your GP will probably refer you to a sleep specialist for further investigation.
Analyze Your Score
0-7: It is unlikely that you are abnormally sleepy. 8-9: You have an average amount of daytime sleepiness. 10-15: You may be excessively sleepy depending on the situation. You may want to consider seeking medical attention.
Diagnosing narcolepsy
Two specialized tests, which can be performed in a sleep disorders clinic, are required to establish a diagnosis of narcolepsy: Polysomnogram (PSG or sleep study)—The PSG is an overnight recording of brain and muscle activity, breathing, and eye movements.
Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause. major psychological stress. an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix)
A person with narcolepsy is extremely sleepy all the time and, in severe cases, falls asleep involuntarily several times every day. Narcolepsy is caused by a malfunction in a brain structure called the hypothalamus. Mild cases of narcolepsy can be managed with regular naps, while severe cases need medication.
Excessive daytime sleepiness is usually the first sign of narcolepsy. It can have a significant impact on everyday life. Feeling drowsy throughout the day and struggling to stay awake makes it difficult to concentrate at work or school. People with narcolepsy may be misjudged as being lazy or rude.
By this criterion, the reference range of 'normal' ESS scores is zero to 10. That is the same as the range defined by the 2.5 and 97.5 percentiles.
0-5 lower normal daytime sleepiness. 6-10 normal daytime sleepiness. 11-12 mild excessive daytime symptoms. 13-15 moderate excessive daytime symptoms.
The Epworth Sleepiness Scale (ESS) is a validated 8-item measure of daytime sleepiness. On the ESS respondents estimate how likely they are to doze in eight different situations. The scores are based on a 0-to-24-point scale, with higher scores representing greater levels of sleepiness.
Narcolepsy is not considered a disability under the NDIS, nor is it considered eligible for the disability support pension (DSP). An April 2019 inquiry report to the Australian Parliament includes feedback from people with the condition and their issues with finding support.
A Sleep Physician
Thorpy, the director of the Sleep-Wake Disorders Center at the Montefiore Medical Center in Bronx, NY, says that he recommends that narcolepsy patients be in bed for a minimum of eight hours each night, have a regular wake-up time, and hold these constant for two weeks.
The onset of narcolepsy can occur anytime between early childhood and 50 years of age. Two peak time periods have been identified; one around 15 years of age and another around 36 years of age. Some researchers believe that narcolepsy is under-diagnosed in children.
The differences between the types of narcolepsy
You may experience cataplexy, sleep paralysis, hallucinations and insomnia with type 1 narcolepsy. People with type 2 do not suffer from cataplexy and generally have normal levels of hypocretin.
Narcolepsy is a neurological disorder that affects approximately 3 in 10,000 Australians. There are limited effective treatment options available in Australia.
Whatever the age of onset, patients find that the symptoms tend to get worse over the two to three decades after the first symptoms appear. Many older patients find that some daytime symptoms decrease in severity after age 60.
The hallmark symptom of narcolepsy is an excessive daytime sleepiness (EDS), in which a person falls asleep at times when they want to be awake. EDS may include daytime sleep attacks that occur with or without warning, persistent drowsiness and fleeting moments of sleep that occur in between a person's waking state.
Avoid alcohol and caffeine, especially before bedtime. "Alcohol causes sleep fragmentation, which means that it breaks up our sleep," Awad says. Alcohol interrupts the restorative REM sleep stage, which can leave you feeling sleepy the next day, even when you feel like you've had a full night's sleep.
Narcolepsy can be diagnosed on the basis of a history of typical episodes and the results of an overnight sleep study with a multiple sleep latency test. The sleep study checks for other explanations that could account for daytime sleepiness, such as sleep deprivation, sleep apnoea and depression.
In addition to the above, Stanford Sleep Specialists will commonly performed a blood genetic test for narcolepsy if they suspect hypocretin deficiency called Human Leukocyte Antigen (HLA) DQB1*06:02 typing.
Imaging studies such as MRI are useful for excluding rare causes of symptomatic narcolepsy. Structural abnormalities of the brain stem and diencephalon may present as idiopathic narcolepsy. In patients with secondary narcolepsy, MRI of the brain may show various abnormalities that correspond to the underlying cause.