Robert Wood Johnson University Hospital
New Brunswick • Somerset

Epworth Sleepiness Scale

Take this assessment, the Epworth Sleepiness Scale, to see if you are too sleepy.

*Please note: All fields marked with an asterisk are required.

Your Information
* First Name
* Last Name
* Email
* Phone
* Gender
Date of Birth - mm/dd/yyyy
Assessment

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven't done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:

* Please select your chance of dozing for each situation

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

* Sitting and reading
* Watching TV
* Sitting, inactive in a public place (e.g.: theater, meeting)
* As a passenger in a car for an hour without a break
* Lying down to rest in the afternoon when circumstances permit
* Sitting and talking to someone
* Sitting quietly after lunch without alcohol
* In a car, while stopped for a few minutes in traffic
* Please validate

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