Epworth Sleepiness Scale

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Epworth Sleepiness Scale

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Compliance

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Name* This field is required.
First Name
Last Name
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UniqueID* This field is required.
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What is the patient's email?
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We have described 8 situations. Choose the most appropriate number for each situation.
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Situation: Sitting and reading
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: Watching TV
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: Sitting, inactive in a public place (i.e., movie theater or restaurant)
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: As a passenger in a car
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: Lying down to rest
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: Sitting and talking to someone
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: Sitting quietly after a meal without alcohol
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Situation: In a car, while stopped for a few minutes in traffic or at a light
Would never nod off
Slight chance of nodding off
Moderate chance of nodding off
High chance of nodding off
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Today's Provider* This field is required.
Please Select
Please Select
Guy M. Lerner, MD
Leslie Dally, DO
Don Zinno, APRN
Erika Ruth, MD
Craig Rouben, APRN
Tara O'Brien, APRN
Monica Taylor, APRN, PMHNP
Brandi Thomas, APRN, PMHNP
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Screening Test
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Date
Date
Month
Day
Year
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ScoreESS >10 suggests excessive daytime sleepiness
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Grading
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ALERT
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