As with any other medical condition, diagnosis depends on history, examination and investigation. A number of questionnaires have been developed in sleep medicine and some of these have been used to identify which patients should be investigated
The most ubiquitous of these is the Epworth Sleepiness Scale (ESS). This was developed by Dr Murray Johns at the Epworth Hospital in Australia. Dr Johns never intended this to be used as a screening tool, but because of its simplicity it has been used worldwide. There have been a number of papers published demonstrating that it is not a good screening tool, but the practice persists. It is a useful tool to estimate how sleepy an individual is during the daytime but it is a subjective assessment and is influenced by both the patient and the clinician. It is also important to appreciate that daytime sleepiness develops over a long period in OSA. It is possible to have a severe degree of OSA, but not be sleepy during the day. However, the other physiological consequences are still present.
LACK OF DAYTIME SLEEPINESS DOES NOT EXCLUDE A DIAGNOSIS OF OSA
STOP BANG This has been developed as a screening tool by Professor Frances Chung (University of Toronto).