Dentist Uncovers A Hidden Medical Condition With A Simple “Sleepiness” Tool
No matter how long you sleep, you still feel tired. Daytime fatigue is interfering with your ability to enjoy life to the fullest. You never feel rested or “your best.” Conditions such as a compromised or restricted airway can cause you to stop breathing many times each night – and you may not even realize that your body is abruptly waking itself as an act of self-preservation. No wonder you feel tired all of the time! You have come to the right place for prompt treatment of these disturbing conditions. VIA Health Group in Canton, Ohio, starts with a thorough evaluation. From there, we can make recommendations to get you on the road to health and back to enjoying some quality ZZZZ’s.
“His wife was totally shocked. She had no idea that her husband was that tired.”
Do you feel tired often? Are you sleepy during the day? Do you struggle with fatigue?
Those are the kind of questions I recently asked a young mom who came in to see me about a dental problem.
She reported feeling a little tired sometimes, but dismissed it by chalking it up to being a new mom. But relying on self reporting is a problem.
Self Reporting Of Fatigue / Sleepiness Is Difficult
It’s unreliable. It’s very difficult for individuals to directly assess and quantify their own fatigue or sleepiness.
And because daytime sleepiness is a very common symptom of a potentially deadly sleep disorder (sleep apnea), it’s important that we take it seriously and quantify it the best we can.
Fortunately, we have a great tool to help us with this. It’s called The Epworth Sleepiness Scale (ESS) questionnaire1.
But before jumping into the nuts and bolts of this questionnaire, let me share with you an interesting ESS result I had recently.
He Normalized His Fatigue
A middle-aged male patient came in to see me and filled out the questionnaire. His score was very high, which put him into the category of “Severe Excessive Daytime Sleepiness”.
His wife was totally shocked. She had no idea that her husband was that tired. She had no clue that he was pushing that hard to get through each day. His fatigue was something he and his wife just never discussed.
He wasn’t even fully aware of it himself. He was normalizing his chronic fatigue, which unfortunately, is a common problem2. He just always assumed his energy levels were “normal” for this age.
His Physician Was Unaware Too
He was later diagnosed with obstructive sleep apnea (OSA). And even his physician was surprised. His fatigue was never something that was brought up at any previous exam.
We were able to eventually treat his sleep apnea with an oral sleep appliance. And according to his last report, he told me. “I feel like a new person”
What Exactly Is The Epworth Sleepiness Scale (ESS)?
The Epworth Sleepiness Scale (ESS) works like this. You score each situation listed below by answering the following question:
How likely are you to doze off or fall asleep in the following situation, in contrast to feeling just tired?
This refers to your usual way of life in recent times.
Even if you haven’t done some of these things recently, try to work out how they would have affected you.
Use the following scale to choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
It is important that you answer each question as best you can.
- Sitting and reading
- Watching TV
- Sitting, inactive in a public place (e.g. theatre or a meeting)
- As a passenger in a car for an hour without a break
- Lying down to rest in the afternoon when circumstances permit
- Sitting and talking to someone
- Sitting quietly after a lunch without alcohol
- In a car, while stopped for a few minutes in the traffic
Total your score and refer to the chart below:
0-5 = Lower Normal Daytime Sleepiness
6-10 = Higher Normal Daytime Sleepiness
11-12 = Mild Excessive Daytime Sleepiness
13-15 = Moderate Excessive Daytime Sleepiness
16-24 = Severe Excessive Daytime Sleepiness
Don’t Let The Perfect Be The Enemy Of The Good
The ESS questionnaire is not perfect, but it does give us a good general idea of how you compare to the rest of the population.
I often say you can’t really try on someone else’s tiredness. Some people are extremely tired but plow through life and make things “work” because they have responsibilities. While others are just always tired and they tell you all about it. The ESS questionnaire helps us adjust for that reality.
Spouses Can Help Solve The Puzzle
In some cases, patients may claim they would never fall asleep in any of the above situations. One reason may be because they don’t want to appear weak. But when their spouses are present, the spouse will sometimes strongly disagree. “Oh no. He falls asleep all the time!” That kind of feedback helps.
We have some patients who immediately make the connection between their high ESS score and their medical problems like high blood pressure, unexplained weight gain, snoring, diabetes, or even dental problems.
And that’s exactly what happened to the young mom I mentioned at the beginning of this article. She came in to fix one crooked tooth, but ended up fixing so much more.
We were able to uncover the fact that her restricted airway / sleeping disorder was responsible for more than her crooked teeth. It was also responsible for a few other negative health outcomes too (e.g. fatigue, headaches, lack of focus, etc.).
The ESS questionnaire really helped us start and bring that journey of discovery to the surface.
Come See Us
Do you feel tired often? Are you sleepy during the day? Do you struggle with fatigue? If so, don’t ignore it. Taking this action might just change your life.
Come see us. We can talk virtually or in person. We’ll help you connect the dots to a better life.
Dr. Jeff Danner is a craniofacial sleep medicine certified provider in the Canton, Ohio area. He has successfully treated patients from all over the world suffering from jaw joint and facial pain, headaches and sleep apnea.