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Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD)
Please visit this website for the instrument: Epworth Sleepiness Scale for Children and Adolescents
Supplemental: Spinal Cord Injury (SCI)-Pediatric (for ages 12 - 18)
Short Description of Instrument
The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is like the adult Epworth Sleepiness Scale (ESS) (Johns 1991) except for changes to instructions and descriptions of activities that make the scale more comprehensible to children and adolescents (Johns 2015a, 2015b).
The ESS-CHAD differs from the ESS in the following ways (Johns 2015b):
    • The recall interval is more clearly specified as 'over the last month'.
    • The reference to alcohol is omitted from question 7, and 'a classroom at school' is specified as the public place in question 3.
    • Question 8 is replaced by a question asking about falling asleep while 'sitting and eating a meal'.

The ESS-CHAD is like the adult ESS in that the conceptual framework is the same, it is scored the same way, and the activities of both scales have the same relative somnificities.
Population: Children and adolescents 5-18
Rated from 0-24, with high scores indicating worse sleepiness. Janssen et al, (2017) has shown the EES-CHAD to be valid, reliable, and unidimensional.
Strengths/Weaknesses: The ESS-CHAD has been successfully modified to subjectively assess sleepiness in children and adolescents. More evidence supporting its psychometric properties in pediatric SCI is warranted.
Key references:  
Johns M. The assessment of sleepiness in children and adolescents. Sleep Biol Rhythm. 2015a;13:97.
Johns MW. Epworth sleepiness scale for children and adolescents (ESS-CHAD). 2015b Accessed from: 06 March 2019.
Additional references:  
Janssen KC, Phillipson S, O'Connor J, Johns MW. Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis. Sleep Med. 2017;33:30-35.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
Melendres MC, Lutz JM, Rubin ED, Marcus CL. Daytime sleepiness and hyperactivity in children with suspected sleep-disordered breathing. Pediatrics. 2004;114(3):768-775.
Meltzer LJ & Mindell JA. Sleep and sleep disorders in children and adolescents. Psychiatr Clin North Am. 2006;29(4):1059-1076.
Wang YG, Benmedjahed K, Lambert J, Evans CJ, Hwang S, Black J, Johns MW. Assessing narcolepsy with cataplexy in children and adolescents: development of a cataplexy diary and the ESS-CHAD. Nat Sci Sleep. 2017;9:201-211.


Document last updated July 2020