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Use the Epworth Sleepiness Scale to Assess Your Risk of Sleep Apnoea

Epworth Sleepiness Scale Snoring

Use the Epworth Sleepiness Scale to Assess Your Risk of Sleep Apnoea

Obstructive sleep apnoea (OSA) is a serious sleep disorder, which if left undiagnosed increases the risk of stroke, heart attack, Type 2 diabetes and liver disease. It is caused by the narrowing of the upper airways, resulting in sleep which can be interrupted numerous times during the night. 

But once you’re diagnosed, there are treatments to manage the condition, allowing you to lead a normal lifestyle again. Therefore, recognising the potential signs and obtaining a diagnosis is key. 

The Epworth Sleepiness Scale is a quick way to assess your risk of sleep apnoea. 

There are just eight situations including:

  • Watching TV
  • Reading
  • As a car passenger for over an hour without a break
  • Sitting and talking to someone
  • Lying down for a rest in the afternoon

Score yourself on how likely you are to doze or fall asleep in these situations, with 0 being never, and 3 being very likely.

Add up the total; this is your Epworth Score.

0-10 – low risk, your sleepiness levels are normal, but you may could still have Sleep Apnoea if you have other symptoms including excessive snoring. Find out the other symptoms here.

10-15 – Medium risk, your sleepiness is above normal. You should consider a sleep test, particularly if you have other symptoms.

16+ – High risk. Your sleepiness levels are considerably higher than normal levels. You should take a sleep test as soon as possible.

In-Home Testing

An initial screening test, called an Overnight Oximetry, can be taken from the convenience of your own home. It can involve wearing a band around the chest or placing a clip on the finger while you sleep. 

These simple devices are connected to a recording monitor, the Oximeter, which records blood oxygen levels and heart rate. Other information which may also be recorded relates to body movement during the night and snoring. The test may need to be run for one or two nights and when complete the results are analysed by trained sleep specialists who will soon be able to advise you on the diagnosis.

Determining the Severity of OSA

The main index in calculating the severity of a person’s sleep apnoea is the Apnoea Hypopnoea Index (AHI). It is based on the number of events per hour recorded while you sleep. These events are the times your airways become blocked, resulting in you awakening. The higher the number of events the more severe your OSA. Three levels are used for AHI which are:

Mild – AHI reading of 5 to 14 events each hour

Moderate – AHI reading of 15 to 30 events each hour

Severe – AHI reading of over 30 events each hour

The index is used to help determine the treatment required to manage the OSA and address some of the potential causes. As OSA can lead to severe health problems, an accurate diagnosis is important in treating the disorder.

Treatment of OSA

Having an In-Home test, using the Epworth Sleepiness Scale and calculating your AHI are all important steps toward diagnosis and treatment for OSA, which can help prevent serious health problems developing from this sleep disorder. A doctor can now discuss the possible treatment options appropriate to your severity of OSA as shown by your AHI calculations.

In most instances you will be recommended to make some everyday changes if elements of your lifestyle may be contributing to having Obstructive Sleep Apnoea. These changes may include losing weight, quitting smoking and reducing your alcohol intake. You may be advised regarding a healthier diet and also to exercise which can often help you to sleep.

The position you sleep in can affect OSA so your doctor may also recommend positional therapy. Some people will largely suffer with OSA when sleeping on their back and can be supplied with a device worn on the back or waist at night which ensures they sleep on their side. However, in most cases this tends to only reduce the effects of OSA and not completely eliminate them.

For mild to moderate OSA sufferers: it may be recommended they wear a device which helps to keep their airways free during the night. This could be a Mandibular Advancement Device, a mouthguard like appliance which pushes the lower jaw down as you sleep, opening the airway and allowing you to breathe freely through the night.

More severe OSA sufferers: it may be recommended to try Continuous Positive Airways Pressure (CPAP) therapy. This involves wearing a mask which is attached to a machine that pumps a steady supply of air to prevent your airways closing. The mask can be worn over the nose, mouth or both, whichever you find most comfortable. CPAP therapy can take some getting used to but is seen as the most effective form of treatment for severe OSA.

Talk to your doctor

Whichever form of treatment is recommended, this stage can only be reached after a diagnosis. Working with those closest to you can help identify whether you show the main symptoms for OSA, before an In-Home test provides a diagnosis. 

Once you have the all-important diagnosis you can work with the professionals to treat your OSA and remove the debilitating side-effects associated with the disorder, including constant fatigue.

When you had initial concerns about the possibility of Obstructive Sleep Apnoea, you may have asked your partner, a friend or a family member to keep an eye on you while you were asleep. Unfortunately, the major symptoms of OSA are not easy to recognise for the sufferer, but an observer can note the level of your snoring and the extent to which your sleep is being interrupted. Their observations may well have helped you decide to take an In-home test.

Download the Epworth Sleepiness Scale: https://www.blf.org.uk/support-for-you/obstructive-sleep-apnoea-osa/diagnosis/epworth-sleepiness-scale

Order the Intus At-Home Sleep Test: https://www.sleeptest.co.uk/product/in-home-sleep-test/



About author: Helen Clarkson is a Sleep Specialist at Baywater Healthcare. Ms. Clarkson has worked with Baywater since 2008, working closely with patients in delivering sleep/bi-level services including sleep and respiratory, both in the home and clinic setting. This includes therapy initiation and troubleshooting support. Ms. Clarkson is responsible for delivering the Baywater Healthcare patient adherence management programme to ensure continuing patient therapy compliance. works in conjunction with NHS clinicians and procurement to deliver excellence in home and clinic-based services. She provides training on all aspects of sleep including devices and interfaces. Previously, Ms. Clarkson served as Respiratory Physiologist at Pontefract General Infirmary. Her position was Senior MTO for lung function/sleep department, and she was responsible for performing simple and complex sleep studies, sleep study analysis, CPAP initiation, therapy adherence and troubleshooting/service clinics, spirometry, lung volumes and transfer factor, reversibility, CPET, hyperventilation testing, EIA testing, skin prick testing, 6 min walk tests. She has also held roles as Respiratory Physiologist and Respiratory Technician, working closely with patients with respiratory disorders -- including ex-miners. Ms. Clarkson has a BSc (Honors) in Applied biology from University of Staffordshire. She also studied Developments in Sleep Medicine (advanced course) at St. Thomas’ Hospital, and took the Edinburgh Sleep Medicine course. She completed the BSS: Advanced sleep course and the ARTP NIV Course.

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