Epworth Sleepiness Scale (ESS)

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DOB

Referring Physician

Instructions.

Select one score (0-3) for each situation.

0=Would never doze 1=Slight chance 2=Moderate chance 3=High chance

Sitting and reading

Watching television

Sitting inactive in a public place

As a passenger in a car

Lying down to rest in the afternoon

Sitting and talking to someone

Sitting quietly after lunch

In a car while stopped in traffic

Total Score: ______ / 24
Interpretation

0-7 Normal daytime sleepiness
8-9 Average daytime sleepiness
10-15 Excessive daytime sleepiness - Clinical evaluation recommended
16-24 Severe excessive daytime sleepiness - Prompt evaluation recommended

Epworth Sleepiness Scale (ESS)

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Sleepiness Scale

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