Epworth Sleepiness Scale Questionnaire

The Epworth Sleepiness Scale is widely used (^) in the field of sleep medicine as a subjective measure of a patient's sleepiness. Please complete this form only if your clinician has requested that you do so.

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. Please 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. Please answer all the questions.

^ With thanks to ESS’s developer, Dr Murray Johns, who established the Epworth Sleep Centre at the Epworth Hospital in Melbourne in 1988.

    1. Sitting and reading
    No chance of dozing Slight chance Moderate chance High chance of dozing
    2. Watching TV
    No chance of dozing Slight chance Moderate chance High chance of dozing
    3. Sitting inactive in a public place (e.g., a theatre or a meeting)
    No chance of dozing Slight chance Moderate chance High chance of dozing
    4. As a passenger in a car for an hour without a break
    No chance of dozing Slight chance Moderate chance High chance of dozing
    5. Lying down to rest in the afternoon when circumstances permit
    No chance of dozing Slight chance Moderate chance High chance of dozing
    6. Sitting and talking to someone
    No chance of dozing Slight chance Moderate chance High chance of dozing
    7. Sitting quietly after a lunch without alcohol
    No chance of dozing Slight chance Moderate chance High chance of dozing
    8. In a car, while stopped for a few minutes in traffic
    No chance of dozing Slight chance Moderate chance High chance of dozing

    Thank you. Finally, please enter your details then click “Submit”.

    First Name*:
    Last Name*:
    Date of Birth*:
    Phone Number:*: