The Epworth Sleepiness Score
Name:………………….......................................……………………………......................
Date:......….../..………./............
Your age (Yrs)....................Your sex ..........................
How likely are you to doze off or fall asleep in the situations described in the box below, 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:
0 = would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
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Situation
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Score
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Sitting and reading
Watching TV
Sitting inactive in a public place (e.g. a theatre or 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
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Total
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A score of 10 or greater may suggest Obstructive Sleep Apnoea and should be referred
If a patient scores 1 or more for the last situation, then referral is indicated also
Weight:____________ (kg) Height: __________ (metres) BMI: ____________
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