What is the chance you will doze off in the following situations?

Sitting and Reading

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

Watching TV

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

Sitting inactive in a public place, such as a theater or meeting

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

As a passenger in a car for an hour without a break

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

Lying down to rest in the afternoon when circumstances permit

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

Sitting and talking to someone

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

Sitting quietly after a lunch without alcohol

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

In a car, while stopped for a few minutes in traffic

0 – No chance of dozing
1 – Slight chance of dozing
2 – Moderate chance of dozing
3 – High chance of dozing

________ Total Overall Score

Epworth Sleepiness Scale Key

1 to 6:  Congratulations, you are getting enough sleep.
7 to 8:  Your score is average.
9 and up:  Seek the advice of your primary physician or sleep specialist.