Epworth Sleepiness Scale

Please indicate the likelihood that you would fall asleep in the following situations ( scale of 0-3).
Use the following scale to chooose the most appropriate number for each .

Scale
0 - would never doze
1- slight chance of dozing
2 - moderate chance of dozing
3- high chance of dozing

Name

Email address

Situation

1) Sitting and reading
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

2) Watching TV
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

3) Sitting inactive in a public place (eg. theatre or meeting)
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

4) As a passenger in a car for an hour with out a break
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

5) Lying down to rest in the afternoon when circumstances permit.
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

6) Sitting and talking to someone
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

7) Sitting quietly after a lunch without alcohol
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing

8) In a car, while stopped for a few minutes in traffic
would never doze
slight chance of dozing
moderate chance of dozing
high chance of dozing


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