Table 2.
Subjective assessment tools for determining the risk of EDS
| Tool | Measure | Description | Interpretation | Completion time, min |
|---|---|---|---|---|
| ESS [86, 90] | Propensity for daytime sleepiness | 8 items; self-rated; each item scored 0–3 | > 10 indicates EDS | 5 |
| FAS [111] | Propensity for fatigue | 10 items; self-rated; each item scored 1–5 | Range 10–50; 10 is lowest, 50 is highest | 2 |
| FSS [112] | Severity and impact of fatigue | 9 items; self-rated; each item scored 1 (strongly disagree) to 7 (strongly agree) | A higher score indicates more severe fatigue | |
| PHQ-9 [113] | Frequency of depression symptoms | 9 items; self-rated; item #3 relates to sleep | Range 0 (not at all) to 3 (nearly every day) | |
| PROMIS [90] | Sleep quality, depth, and satisfaction | 27 items; self-rated | A higher score indicates more sleep disturbance | 10–15 |
| PROMIS-8 [90] | Sleep quality, depth, and satisfaction | 8 items; self-rated | A higher score indicates more sleep disturbance | 5 |
| FOSQ-30 [90] | Impact of EDS on ADL and QoL | 30 items; self-rated; each item scored 1–4 | A higher score indicates less impact on function | 15 |
| FOSQ-10 [90] | Impact of EDS on ADL and QoL | Short form 10 items; self-rated; each item scored 1–4 | A higher score indicates less impact on function | 5–7 |
| PSQI [90] | Sleep quality and habits during the previous month | 19 items; self-rated and bed-partner-rated (5 items) | Sum of 7 domain scores (range 0–21); a score > 5 indicates poor quality sleep | 5–10 |
| BDI-II [68] | Severity of depression | 21 items; self-rated to capture cognitive, affective, somatic, and vegetative symptoms; 4-point scale from 0 (absent) to 3 (severe) | Range 0–63, with scores of 14–19, 20–28, and 29–63 indicating mild, moderate, and severe impairment, respectively | 5–10 |
| BDI-FS [68, 114] | 7 items; self-rated; short version for family physicians | Range 0–21, with scores of 4–8, 9–12, or 13–21 indicating mild, moderate, or severe impairment, respectively | < 5 | |
| CES-D [115] | Frequency of depression-associated symptoms (e.g., restless sleep) | 20 items; self-rated; each item rated from 0 (rarely) to 3 (most of almost all the time) | Range 0–60, high scores indicate more symptoms of depression |
At minimum, the ESS and BDI should be used for screening patients, but further evaluation may require screening with the other tools listed
ADL activities of daily living, BDI-FS Beck Depression Inventory-Fast Screen, BDI-II Beck Depression Inventory-Second Edition, CES-D Center for Epidemiological Studies–Depression, EDS excessive daytime sleepiness, ESS Epworth Sleepiness Scale, FAS Fatigue Assessment Scale, FOSQ Functional Outcomes of Sleep Questionnaire, FSS Fatigue Severity Scale, PHQ-9 Patient Health Questionnaire-9, PROMIS Patient-Reported Outcomes Measurement Information System, PROMIS-8 Patient-Reported Outcomes Measurement Information System (8 items), PSQI Pittsburgh Sleep Quality Index, QoL quality of life