1.
Epworth Sleepiness ScaleNumber 1 through 8 on a scrap of paper.
2.
1How likely are you to doze off or • Sitting and readingfall asleep in the followingsituations?Answer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
3.
2How likely are you to doze off or • Watching TVfall asleep in the followingsituations?Answer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
4.
3How likely are you to doze off or • Sitting inactive in afall asleep in the following public place (e.g.,situations? theater or meeting)Answer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
5.
4How likely are you to doze off or • As a passenger in afall asleep in the following car for an hoursituations? without a breakAnswer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
6.
5How likely are you to doze off or • Lying down to restfall asleep in the following in the afternoonsituations? when ableAnswer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
7.
6How likely are you to doze off or • Sitting and talkingfall asleep in the following to someonesituations?Answer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
8.
7How likely are you to doze off or • Sitting quietly afterfall asleep in the following a lunch withoutsituations? alcoholAnswer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
9.
8How likely are you to doze off or • In a car whilefall asleep in the following stopped for a fewsituations? minutes in trafficAnswer considering how you feltover the past week or so.0 = Would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
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