The Epworth Sleepiness Scale The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 11 or more is considered sleepy. If you score 11 or more on this test, you should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and /or need to see a sleep specialist. These issues should be discussed with your personal physician. Please answer all of the below questions. How likely are you to fall asleep in the following situations? 0 = Would never doze 1 = Slight chance of dozing 2 = Moderate chance of dozing 3 = High chance of dozing Sitting and reading*Choose One...0 - Never1 - Slight2 - Moderate3 - HighWatching television*Choose One...0 - Never1 - Slight2 - Moderate3 - HighSitting, inactive, in a public place (theater, meeting)*Choose One...0 - Never1 - Slight2 - Moderate3 - HighAs a passenger in a car for an hour with no break*Choose One...0 - Never1 - Slight2 - Moderate3 - HighLaying down to rest in the afternoon, if circumstances permit*Choose One...0 - Never1 - Slight2 - Moderate3 - HighSitting and talking to someone*Choose One...0 - Never1 - Slight2 - Moderate3 - HighSitting quietly after lunch without alcohol*Choose One...0 - Never1 - Slight2 - Moderate3 - HighIn a car while stopped for a few minutes in traffic*Choose One...0 - Never1 - Slight2 - Moderate3 - HighYour score will start to display here when you begin to answer questions above.Your ScoreYour Score Less than 5 points = Lower Range for Normal Daytime Sleepiness 6-10 points = Higher Range for Normal Daytime Sleepiness 11-12 points = Mild Excessive Daytime Sleepiness 13-15 points = Moderate Excessive Daytime Sleepiness 16+ = Severe Excessive Daytime Sleepiness I would like Dr. Berry's office to follow up with me about my results I would like Dr. Berry's office to follow up with me about my results Email the results to me Email the results to me Download the PDF versionName* First Last Phone*Email Address* PhoneThis field is for validation purposes and should be left unchanged.
