Excessive daytime sleepiness in the general population: Experiences from the use of an online Epworth sleepiness scale

<b>Background:</b> Excessive Daytime Sleepiness (EDS) is the most common complaint reported in sleep clinics and is a prevalent cardinal symptom of sleep disorders. We hypothesised that by utilising modern media to deliver an online Epworth Sleepiness Scale (ESS) age and gender related differences in EDS could be assessed. <b>Patients and Methods:</b> During a two-year period (2013-2015) 39,448 subjects completed an online ESS (range 0-24 points) and recorded age and gender. EDS was assumed if ESS scored more than 10 points. <b>Results:</b> A significant trend was found between increasing age and raised ESS score in male subjects (p&lt;0.001), but not in female subjects (p=0.311). Average scores with respect to age reported female subjects to be significantly sleepier up to the end of their 2^nd lifetime decade (p=0.014) and in their 3^rd and 4^th lifetime decade (p&lt;0.001 and p=0.011, respectively). Male subjects conveyed significantly higher levels of sleepiness in their 7^th lifetime decade (p&lt;0.001). Female subjects scored significantly higher than males in items 1, 4 and 5 (p&lt;0.001) whilst male subjects scored higher for items 3, 6, 7 and 8 (p&lt;0.001). Lowest levels of sleepiness were reported for item 8, while item 5 recorded the highest scores. <b>Conclusions:</b> The online ESS identifies gender and age specific differences in EDS, similar to previous data using conventional questionnaires. The use of modern media potentiates a wider outreach in the general population to raise awareness about EDS and associated conditions, such as sleep apnoea.