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Sleep Test No Quick Fix, Say Docs

Online quiz is misleading, new survey reports

MONDAY, June 11, 2001 (HealthDayNews) -- Tired people who take an online sleepiness test may be making a big mistake because the test could be misleading or inaccurate, say researchers at the University of Michigan.

"A normal score may give people a false sense of security," says Dr. Alon Avidan, an assistant professor at the University of Michigan.

But the Australian doctor who invented the test defends its accuracy, although he agrees with his critics that it should be used only by professionals.

The Epsworth Sleepiness Scale, first developed in 1991, asks users to rank how likely they are to fall asleep during eight activities that range from driving to watching television. The test can be found on approximately 90 health Web sites.

"The main point is to allow people to find out if they have mild, moderate or severe sleepiness," says Avidan. Researchers at the university studied the test's widespread use on the World Wide Web and presented their findings at a June 7 conference of the Associated Professional Sleep Societies.

Avidan calls the test a "crude" way to assess sleepiness, and says that the health Web sites that offer it don't give enough information to help users understand what the results mean. Only some of the health Web sites advised users to contact their doctors if they felt they had a sleep problem.

Users could assume that they have a sleep disorder when the causes of tiredness may be psychological, Avidan says. "The reasons why people are sleepy can be very extensive. It can range anywhere from the most common reason, insufficient sleep time, to depression."

Sleep disorders include narcolepsy (uncontrollably and spontaneously falling asleep) and apnea (waking up many times during the night but being unaware of doing so).

Most importantly, the health Web sites did not indicate that the Epsworth test is controversial, Avidan adds.

Avidan acknowledges that doctors at the University of Michigan do occasionally use the test. But he says the "gold standard" of measuring sleepiness is a test known as Multiple Sleep Latency that is given at sleep laboratories.

That test can cost $500 to $800, he adds.

Dr. Murray Johns, the Australian physician who invented the Epsworth test, says most sleep experts support its use and feel "confident" about it. Laboratory tests often measure how quickly subjects fall asleep, instead of how often they get sleepy during the day, he says. According to Johns, the lab tests miss the big picture.

While Johns has allowed magazines to reprint his test, he says it should not be used unless warnings are included for readers.

"They can use it as a fun thing, but it was never intended to be a fun thing," he says. "It's a scientific instrument and could be quite misleading."

What To Do

Tiredness during the day is not normal. Instead of taking an online test, consider talking to your physician.

Approximately 100 million Americans have sleep problems, ranging from sleep walking to sleep terrors. Learn about a wide variety of conditions at the American Academy of Sleep Medicine.

This site operated by the Celphalon drug company describes sleep disorders that are specifically related to daytime tiredness.

You also might want to read previous HealthDay articles on sleep.

SOURCES: Interviews with Alon Avidan, M.D., clinical assistant professor, Department of Neurology, Michael S. Aldrich Sleep Disorders Laboratory, University of Michigan, Ann Arbor; Murray Johns, M.D., Ph.D., director, Sleep Disorders Unit, Epworth Hospital, Melbourne, Australia
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