Epworth

Epworth Sleepiness Scale
Name*

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Date

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Date
Type a question

How likely are you to nod off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently, try to work out how they would have affected you. It is important that you answer each question as best you can. Use the following scale to choose the most appropriate number for each situation.*

	Would never nod off 0	Slight chance of nodding off 1	Moderate chance of nodding off 2	High chance of nodding off 3
Sitting and reading
Watching TV
Sitting, inactive, in a public place (e.g., in a meeting,theater, or dinner event)
As a passenger in a car for an hour or more without stopping for a break
Lying down to rest when circumstances permit
Sitting and talking to someone
Sitting quietly after a meal without alcohol
In a car, while stopped for a few minutes in traffic or at a light

Number
Signature*

Clear
Should be Empty:

Epworth Sleepiness Scale