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The Stanford Sleepiness Scale(SSS), developed by William C. Dement and colleagues in 1972, is a one-item self-reportquestionnaire measuring levels of sleepiness throughout the day. The scale has been validated for adult populations and is generally used to track overall alertness at each hour of the day. The SSS is used in both research and clinical settings to assess the level of intervention or effectiveness of a specific treatment in order to compare a client's progress.
Reliability and validity
Reliability
Reliability refers to whether the scores are reproducible. Unless otherwise specified, the reliability scores and values come from studies done with a United States population sample.
Rubric for evaluating norms and reliability for the General Behavior Inventory (table from Youngstrom et al., extending Hunsley & Mash, 2008; *indicates new construct or category)
Criterion
Rating (adequate, good, excellent, too good*)
Explanation with references
Norms
Not applicable
Mean and standard deviation do not exist because the SSS is a single item questionnaire.
Follows characteristics of alertness, but sleepiness is not unidimensional and difficult to quantify
Construct validity (e.g., predictive, concurrent, convergent, and discriminant validity)
Good
Shows convergent validity with other symptom scales such as ESS and Karolinska Sleepiness Scale, prediction of performance after sleep deprivation
Discriminative validity
Adequate
Studies do not report AUCs, some mention overlap between sleepiness, physical tiredness, and depression
Validity generalization
Good
Evidence supports use in a variety of research and clinical settings, but only in persons of 18 years and older
Treatment sensitivity
Not applicable
SSS is not intended for use as a measure of outcome
Clinical utility
Adequate
Free (public domain), brief, easy administration
Development and history
The SSS was developed to measure subjective sleepiness in research and clinical settings. Other instruments measuring sleepiness tend to examine the general experience of sleepiness over the course of a day, but the SSS met a need for a scale measuring sleepiness in specific moments of time. Because it can be used to evaluate specific moments, the scale can be used repeatedly at different time intervals in a research study or for treatment intervention.
Use in other populations
Since the development of the SSS, there have been other more specific and more recently developed sleepiness rating scales, such as the Epworth Sleepiness Scale, which is more commonly used in other populations. Due to the fact that it has only been translated into English, it is not significantly used in other populations.
Limitations
The primary limitations of the Stanford Sleepiness Scale is that it is a self-report measure, because of this, levels of sleepiness may be over or under reported based on personal biases.
