According to the National Institutes of Health (NIH), at least 40 million Americans each year suffer from chronic, long-term sleep disorders, and an additional 20 million experience occasional sleeping problems. These disorders and the resulting sleep deprivation interfere with work, driving and social activities.
The questionnaire below - called the Epworth Sleepiness Scale - was developed by Dr. Murray Johns of Melbourne, Australia, to measure daytime sleepiness. The following questions will ask how likely are you to doze off or fall asleep in the certain situations, in contrast to just feeling tired.
Please remember that the Epworth Sleepiness Scale can't give you a diagnosis, but it can help you determine whether you need to be tested further for a more serious sleep disorder. Doctors use the scale to measure how sleepy a person generally is, and to decide whether he or she needs a full evaluation or sleep study - particularly those with potential sleep apnea or narcolepsy.
To arrange for a sleep consultations with one of our sleep specialists, please call 216.444.2165 or toll free 800.223.2273, extension 42165.
Epworth Sleepiness Scale
Use the following scale to choose the most appropriate number, as it best applies to you.
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
| Situation |
Chance of Dozing |
| Sitting and reading |
1 2 3 |
| Watching TV |
1 2 3 |
Sitting inactive, in a public place
(e.g. a theater or meeting) |
1 2 3 |
| As a passenger in a car for an hour without a break |
1 2 3 |
| Lying down to rest in the afternoon when circumstances permit |
1 2 3 |
| Sitting and talking to someone |
1 2 3 |
| Sitting quietly after a lunch with no alcohol |
1 2 3 |
| In a car, while stopped for a few minutes in traffic |
1 2 3 |
|
YOUR TOTAL: |
Interpreting Your Results
A score equal to or higher than 10 is an indication of significant daytime sleepiness, which can be a sign of a serious sleep disorder.
However, some people with serious sleep problems may have normal scores. Check with your doctor if sleepiness affects your ability to function during the day.
Fatigue Severity Scale
Use the following scale to choose the most appropriate number, as it best applies to you.
Circle a number from 1 to 7 that indicates the degree of agreement with each statement. 1 indicates strongly disagree, 7 indicates strongly agree.
| Time Period: last week |
CIRCLE YOUR RATING |
| My motivation is lower when I am fatigued |
1 2 3 4 5 6 7 |
| Exercise brings on my fatigue |
1 2 3 4 5 6 7 |
| I am easily fatigued |
1 2 3 4 5 6 7 |
| Fatigue interferes with my physical conditioning |
1 2 3 4 5 6 7 |
| Fatigue causes frequent problems for me |
1 2 3 4 5 6 7 |
| My fatigue prevents sustained physical functioning |
1 2 3 4 5 6 7 |
| Fatigue interferes with carrying out certain duties and responsibilities |
1 2 3 4 5 6 7 |
| Fatigue is among my three most common disabling symptoms |
1 2 3 4 5 6 7 |
| Fatigue interferes with my work, family or social life |
1 2 3 4 5 6 7 |
|
YOUR TOTAL: |
Interpreting Your Results
A score equal to or higher than 36 is ABNORMAL. Please consult your physician or a sleep specialist.
