Everyone feels a dip in their daytime energy level at some point — daydreaming for a nap — but how do you know if your sleepiness is normal or a cause for concern? It might not be easy to find out, until you see a specialist, such as a pulmonologist, who can guide you through a simple series of questions called the Epworth Sleepiness Scale.
“This subjective evaluation assesses a patient’s level of daytime sleepiness. It’s a simple questionnaire that can help quantify how you perceive your daily somnolence intensity,” explains George Torres, pulmonologist at AdventHealth Centers for Pulmonary Disease at Apopka.
The questionnaire asks you to rate from zero to three how likely you are to doze off or fall asleep in a few specific situations, compared to just feeling fatigued.
Zero is “would never fall asleep,” leading up to three, which is “high chance of falling asleep.”
Here are the situations to rate:
- Sitting and reading
- Watching TV
- Sitting, inactive in a public place (e.g. a theater or meeting)
- As a passenger in a car for an hour without a break
- Lying down to rest in the afternoon
- Sitting quietly after a lunch (without alcohol)
- In a car, while stopped for a few minutes in traffic
At the end, tally up your rating for each situation. The higher your total number, the more perceived sleepiness you are experiencing.
“In addition to the test, we assess clinical factors, too, to determine if somnolence is related to a sleep disorder or another disorder unrelated to sleep,” says Dr. Torres.
He adds, “One of the most common reasons for increased daytime sleepiness is obstructive sleep apnea, and the Epworth Sleepiness Scale can be one initial screening tool for diagnosing this.”
About Sleep Apnea
Dr. Torres advises that there are different types of sleep apnea.
“Central sleep apnea is a brain disorder that affects the respiratory center. There’s a disturbance in the brain that stops the signaling to the muscles that control your breathing, so you can have trouble maintaining your airway during sleep,” describes Dr. Torres.
Central sleep apnea can occur for a number of reasons, such as stroke, brain infection, conditions that affect the cervical spine, severe obesity and medications such as narcotic pain medications.
“The other type of sleep apnea is called obstructive sleep apnea. While it also causes you to stop breathing during sleep, it’s caused by a narrow or blocked airway from anatomical differences in the throat tissues,” explains Dr. Torres.
“When your muscles that help keep your airway open relax during sleep, some throat tissues can block the airway.”
Loud snoring can be a symptom of obstructive sleep apnea, but snoring can be due to other factors, too.
Why It’s Important to Find and Treat Sleep Apnea
“We have gained a greater understanding of how to recognize and treat sleep apnea,” says Dr. Torres.
“Many people don’t realize that the space shuttle Challenger disaster and even the Exon Valdez oil spill were both related to operator sleep apnea. It can cause devastating car and other occupational accidents if unrecognized and untreated.”
The positive note is that there are many effective treatments for sleep apnea. Dr. Torres explains that sometimes, weight loss alone can help. In more severe cases, ventilator units may be prescribed for use during sleep, which can help protect patients as well as improve sleep and daytime alertness.
Dr. Torres concludes, “The most important message is to recognize if you are feeling chronic daytimes sleepiness and talk to your doctor about it. Your doctor can then connect you to a pulmonologist who can do further examination and testing to determine if you have a sleep-related disorder that is affecting your breathing and provide a treatment plan to improve your health, safety and quality of life.”
Learn more about pulmonary care at AdventHealth Apopka.