Epworth Sleepiness Scale

Patient Name:

First NameLast Name

Date of Birth

Date

Date Of Exam:

Date

The Epworth Sleepiness Scale is widely used in the field of sleep medicine as a subjective measure of a patient's sleepiness. The test is a list of eight situations in which you rate your tendency to become sleepy on a scale of 0, no chance of dozing, to 3, high chance of dozing. When you finish the test, add up the values of your responses. Your total score is based on a scale of 0 to 24.

The scale estimates whether you are experiencing excessive sleepiness that possibly requires medical attention.

How Sleepy Are You?

How likely are you to doze off or fall asleep in the following situations?

You should rate your chances of dozing off, not just feeling tired. Even if you have not done some of these things recently try to determine how they would have affected you. For each situation, decide whether or not you would have:
· No chance of dozing =0
· Slight chance of dozing =1
· Moderate chance of dozing =2
· High chance of dozing =3

Write down the number corresponding to your choice in the right hand column.

Total your score below.

Sittng and Reading

0123

Watching TV

0123

Sitting inactive in a public place (e.g a theater or a meeting)

0123

As a passenger in a car for an hour without break

0123

Lying down to rest in the afternoon when circumstances permit

0123

Sitting and talking to someone

0123

Sitting quietly after a lunch without alchol

0123

In a car while stopped for a few minutes in traffic

0123

Total Score

Interpretation:
0-7:It is unlikely that you are abnormally sleepy.
8-9:You have an average amount of daytime sleepiness.
10-15:You may be excessively sleepy depending on the situation. You may want to consider
seeking medical attention.
16-24:You are excessively sleepy and should consider seeking medical attention.
Reference: Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep
1991; 14(6):540-5.