Self-Evaluation Sleep Quiz

Epworth Sleepiness Scale

 

0 = No Chance of Dozing Off

1 = SLIGHT CHANCE OF DOZING OFF

2 = MODERATE CHANCE OF DOZING OFf                                                 

3 = HIGH CHANCE OF DOZING OFF                                     

 

Rate the chance that you will dose off in the following situations

Sitting and Reading                                                                                        ________

Watching Television                                                                                       ________

Sitting Inactive in a Public Space (e.g. a theater or a meeting)              ________

As a Passenger in a Car Riding for an Hour without Breaks                  ________

Lying Down in the Afternoon when Circumstances Permit                  ________

Sitting and Talking to Someone                                                               ________

Sitting Quietly after Lunch without Alcohol                                           ________

In a Car while Stopped for a Few Minutes in Traffic                              ________

       Add above for total score:                                                               ________

 

Less than 8: indicates reported normal daytime alertness        

8-11: indicates mild sleepiness                                               

12-15: indicates moderate sleepiness                                       

16-24 indicates severe sleepiness