Ask the care expert: How do you conduct a sleep assessment?

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
We are expected to do a lot of assessments. Is there one for sleep? We have many residents who sleep different amounts of time, and I am not sure what is too much or not enough sleep for them.

Yes, there is the “Epworth Sleepiness Scale,” which can be used for both an initial and an ongoing comparative assessment for sleep, or lack thereof.

This “ESS” is used to measure excessive sleepiness or excessive daytime sleepiness and differentiates between average sleep and significant issues with sleepiness that require interventions. Score the answers 0-3, with 0 being “would never doze” and 3 being “ high chance of dozing.” A sum of 9 or more from the eight individual scores reflects “very sleepy and should seek medical advice.”

The nurse can read the statements to the clients allowing them to respond verbally to the answers. This scale can be used across the continuum of care for all older adults.

The questions include:

A. Sitting and standing—What are your chances of dozing? 0=would never doze, 1=slight chance of dozing, 2=moderate chance of dozing, and 3=high chances of dozing.

B. Watching television—same question and answer options as A.

C. Sitting inactive in a public place (movie theater or meeting)—same question and answer options as A.
All eight questions are very easy to answer. You would total the answers to score the results.
The key is basically as follows: 1-6—Congratulations you get enough sleep!; 7-8—You are average; and 9 and up—You are very sleepy and should seek medical advice.

This form along with the directions can be found on the “Try this site” from the Hartford Institute of Geriatric nursing. Go to

Please send your resident care-related questions to Sherrie Dornberger at