Epworth Sleepiness Scale

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 have not done some of these things recently, try to work out how they would have affected you.

Use this scale to assess your sleepiness.

Epworth Sleepiness Scale

Please select your chance of dozing in the following situations

Sitting and Reading: *
Watching TV: *
Sitting, inactive in a public place (e.g. a theatre 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 lunch without alcohol: *
In a car, while stopped for a few minutes in traffic: *
Do you have a partner who can answer some questions about your sleep?

Please ask your partner to fill in this part of the questionnaire about your sleep

Does your partner snore loudly in their sleep?
Has the noise been so bad that you have slept in separate rooms?
How often does this occur?
Is the snoring related to a particular sleeping position?
Which position(s)? (tick all that apply)
Is the snoring worse after alcohol?
Does your partner stop breathing during sleep?
How often on average per night does this occur?
How long, on average, do they stop breathing?
Does this occur when they are on their (tick all that apply):
Is your partner restless in their sleep?
Have you noticed a change in your partner’s behaviour?
Does your partner fall asleep easily during the day?
Is your partner usually tired all the time?
Has your partner fallen asleep or become drowsy whilst driving a car?
Does your partner work particularly long hours?