Piedmont Health Group: Your Community Provider for Better Health Care*

Epworth Sleepiness Scale

You can download a printable copy of the Sleepiness Scale by clicking here.

Acrobat Reader is required to view the above linked document.

How likely are you to doze off or fall asleep in the following situations? (Even if you have not done some of these things recently, try to imagine how they would have affected you.) Use the following scale to choose the most appropriate number for each situation. Add each line and enter total at the bottom of the page.

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

SituationChance of dozing
Sitting & Reading 0 1 2 3
Watching T.V. 0 1 2 3
Sitting inactive in a public place (i.e. theater) 0 1 2 3
As a passenger in a car without a break 0 1 2 3
Lying down to rest in the afternoon 0 1 2 3
Sitting and talking to someone 0 1 2 3
Sitting quietly after lunch without alcohol 0 1 2 3
In a car, while stopped for a few minutes in traffic 0 1 2 3

TOTAL: