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Home
About
About David
Sleep Speaker
Clinic
Attend Appointment
About the Clinic
Telehealth Consultations
Sleep Studies
Questionnaires & forms
Registration form
Prescription requests
FAQs
About Sleep
SleepHub
Sleep Research
Contact
Epworth Sleepiness Scale
Full Name
*
For the 8 situations in the table below, how likely are you to doze off or fall asleep, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you.
Sitting and reading
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Watching television
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Sitting, inactive in a public place (Eg a theatre or meeting)
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
As a passenger in a car for an hour without a break
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Lying down to rest in the afternoon when circumstances permit
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Sitting and talking to someone
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Sitting quietly after lunch without alcohol
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
In a car, while stopped for a few minutes in the traffic
*
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Total Score
Send a copy
Enter email address if you would like a copy of the completed questionnaire.
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