| Sleep Assessment

Epworth Sleepiness Scale (ESS)

Email*

Used to send results only. You will not receive email from us unless requested below.
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Situation
For each of the below situations, please fill in chance of dozing from 0-3.

0 = no chance of dozing
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 a theater or a 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 a lunch without alcohol*
In a car, while stopped for a few minutes in traffic*