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Introduction The Epworth Sleepiness Score (ESS) is a renowned and patented international patient symptom questionnaire. It is used to help diagnose Obstructive Sleep Apnoea Syndrome (OSAS). It consists of eight questions which the patient must answer on a scale of 0 (never) to 3 (highly likely) on the likelihood of dozing or falling asleep in different situations.From many years of experience in sleep disorders, and particularly the diagnosis of Obstructive Sleep Apnoea Syndrome (OSAS) the department found two questions on the ESS which more than often scored low by our patients.These wereSitting inactive in a public place e.g. theatre. meeting and others.In a car while stopped in traffic.The aim of this study was to substitute these questions with two that we felt were more appropriate in assessing for sleepiness and helping to identify patients with possible Obstructive Sleep Apnoea Syndrome.Methods A modified ESS we called the Glenfield Epworth Modified Score (GEMS) was created with two substitute questionsThese questions wereThe likelihood of have recurrent awakenings during your sleepThe likelihood of feeling unrefreshed after your sleep.A clinical audit was then carried out using questionnaires of the ESS and GEMS issued to all patients who were investigated for OSAS with home sleep study equipment (The Resmed Noximeter). These were completed and returned with their sleep equipment after one night’s sleep study in their homes.Results 145 patients who completed the ESS and GEMS showed significantly higher scores with the GEMS questionnaire.The combined score of the two questions from the ESS was 149 compared to 557 from the two Gems substitute questions.The mean results of all 145 patients showed 7.97 from the ESS and 12 from the GEMS. (>10 is deemed significant with the ESS)Conclusion The results and conclusion of this study is that we heavily endorse the use of GEMS as a substitute for the ESS to assess patient symptoms and thus in the diagnosis of OSAS with partial polysomnography sleep studies