The following questionnaire will help you measure your
general level of daytime sleepiness. Answers are rated
on a reliable scale called the Epworth Sleepiness Scale
(ESS) - the same assessment tool used by sleep experts
worldwide. This test was developed by Dr. Murray Johns
at Epworth Hospital in Melbourne, Australia in 1991.
Each item describes a routine daytime situation. Use the
scale below to rate the likelihood that you would doze off
or fall asleep (in contrast to just feeling tired) during that
activity. If you haven't done some of these things recently,
consider how you think they would affect you.
Please note that this scale should not be used to make your
own diagnosis. It is intended as a tool to help you identify
your own level of daytime sleepiness, which can be a
symptom of a sleep disorder.
Use the following scale to answer the questions:
0 = would never doze 2 = moderate chance of dozing
1 = slight chance of dozing 3 = high chance of dozing
Sitting and Reading
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Watching Television
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Sitting inactive in a public place,
for example, a theater or a meeting
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
As a passenger in a car for an hour
without a break
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Lying down to rest in the afternoon
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Sitting and talking to someone
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Sitting quietly after lunch when
you've had no alcohol
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
In a car while stopped in traffic
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Sleep is a health issue; without proper sleep, the human
body cannot function well. Good sleep helps ward off
illnesses, helps maintain healthy skin, bones, and muscles
and helps to balance hormones and other important brain
and body chemicals.
If your total score is 10 or higher, review this form and the
resources that follow with your doctor or other health care provider.
Your health depends on it!
For more information about sleep and sleep disorders,
contact:
Patients:
National Sleep Foundation
1522 K Street, NW, Suite 500
Washington D.C. 20005
www.sleepfoundation.org
(202) 347-3471
American Sleep Apnea Association
1424 K Street NW, Suite 302
Washington, DC 20005
www.sleepapnea.org
(202)293-3650
Narcolepsy Network, Inc.
79 Main Street
North Kingstown, RI 02852
www.narcolepsynetwork.org
(401) 667-2523
Restless Leg Foundation
819 Second Street SW
Rochester, MN 55902-2985
www.rls.org
(507) 287-6465
Talk About Sleep, Inc.
P.O Box 146
Chaska, MN 55318
www.talkaboutsleep.com
(952) 448-5511
Physicians:
American Academy of Sleep Medicine
6301 Bandel Road, Suite 101
Rochester, MN 55901
www.aasmnet.org
(708) 492-0930
American Board of Sleep Medicine
One Westbrook Corporate Center
Suite 920
Westchester, IL 60154
www.absm.org (708) 492-1290
|