Sleep Apnea Quiz!
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Name *
Date Of Birth
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Date
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EPWORTH SLEEPINESS SCALE
This questionnaire was developed to determine the level of daytime sleepiness in individuals. It has become one of the most frequently used methods for determining a person’s average level of daytime sleepiness.

Please rate how likely you are to doze or fall asleep in the following situations by selecting the response that best applies. If you have not done some of these activities recently, select what would most likely happen if you were in that situation.

***IMPORTANT: Write down your scores as you take the quiz!!***
Sitting and reading
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
Watching television
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
Sitting inactive in a public place (eg, a theater or a meeting)
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
As a passenger in a car for an hour without a break
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
Lying down to rest in the afternoon when circumstances permit
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
Sitting and talking to someone
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
Sitting quietly after a lunch without alcohol
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
In a car, while stopped for a few minutes in traffic
Would NEVER Doze
HIGH Chance Of Dozing
Clear selection
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