Epworth Sleepiness Scale

First Name *

Last Name *

Email *

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Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

1. Sitting and Reading

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

2. Watching TV

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

3. Sitting, inactive in a public place (e.g. a theatre or a meeting)

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

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

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

5. Lying down to rest in the afternoon when circumstances permit

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

6. Sitting and talking to someone

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

7. Sitting quietly after lunch without alcohol

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

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

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Current Score

Talk to your GP about your circumstances.

If you scored:

0-5 lower normal daytime sleepiness
6-10 normal daytime sleepiness
11-12 mild excessive daytime symptoms
13-15 moderate excessive daytime symptoms
16-24 severe excessive daytime symptoms

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