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The Epworth Sleepiness Scale

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The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. It is considered the most recognized and widely used questionnaire of its type world wide.

When completing it consider how likely are you to doze or fall asleep in the following situations, in contrast to feeling just tired. Even if you have not done some of these things recently try to work out how they would have affected you.

 

Use the following scale to choose the most appropriate number for each situation:

0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

SITUATION
CHANCE OF DOZING

 

Sitting and reading

Watching TV

Sitting inactive in a pubic place

As a passenger in a car for an hour without a break

Lying down to rest in the afternoon when circumstances

Sitting and talking to someone

Sitting quietly after lunch without alcohol

In a car, while stopped for a few minutes in traffic

If you would like to have the results of this questionnaire confidentially reviewed please submit the following.

Name:  

Phone: 

Email:  

          
  Sleep Management Centers LLC © 2007 Certain statements in this website are based on published material.
You are advised to consult with your physician on any medical concerns.