Background: The Internet is a rich but unregulated source of information, and no studies have evaluated sleep medicine content designed for patient or public use.
Objective: To examine how the Epworth Sleepiness Scale is presented on the World Wide Web.
Methods: We searched the web with eight search engines, in November 2000, for the terms 'ESS' or 'Epworth Sleepiness Scale' and examined every site that listed the full ESS.
Results: The 91 sites were sponsored by academic institutions (n=11), private medical groups (34), corporations (21), and web information services (25). No information on interpretation of ESS results was given by 24 (26%) of the sites; 37 (41%) of the sites stated that a score greater than 8, 9, 10, 11, or 12 merits consultation with a clinician. Few sites mentioned that insufficient sleep and depression are among the most common causes of excessive sleepiness, or that the meaning and value of the ESS are somewhat controversial.
Conclusion: The ESS is widely available on web sites designed for public use, but information that would allow appropriate interpretation of results is often lacking, misleading, or incomplete.