The Epworth Sleepiness Scale

Please complete this form if your doctor or nurse has requested you to fill out an Epworth Sleepiness Scale. The test is a list of 8 situation in which you rate what the chances are of you sleeping on a scale of 0 being unlikely, to 3 being very likely. At the end, you add up your scores for the whole test and end up with a number between 0 – 24.

Analysing the score:

  • 0-7: It is unlikely that you are abnormally sleepy.
  • 8-9: You have an average amount of daytime sleepiness.
  • 10-15: You may be excessively sleepy depending on the situation.
  • 16-24: You are excessively sleepy.

Epworth Sleepiness Scale

Please use this date format: DD/MM/YYYY.

Situation / Chance of Dozing