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Vincent Cumberworth BSc FRCS Consultant Ear,
Nose and Throat Surgeon
Clementine Churchill Hospital Sudbury Hill Harrow Middlesex HA1 3RX
Private Secretary: Tel: 020 8872 3866 Fax: 0208872
3861
Information is supplied only upon the condition that the viewer
will make their own determination as to the suitability of the
information for its purposes prior to use. There will be no
responsibility for information that is misused or misinterpreted and
the information should not be used as a substitute for consultation
with a health care professional. It is not possible to answer
questions regarding individual cases or to enter into individual
correspondence.
THE EPWORTH SLEEPINESS SCALE
Name:…………………………………………………………………………………….
Date:..…………………………………………………………………………………….
Your age: (Yrs)………………….. Your sex (Male = M / Female = F)……………….
How likely are you to doze off or fall asleep in the situations
described in the box below, 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 the following scale to choose the most appropriate number for
each situation:
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
| Activity |
Chance of dozing |
| Sitting reading |
|
| Watching TV |
|
| Sitting, inactive in a public place (eg a theatre or
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 a lunch without alcohol |
|
| In a car while stopped for a few minutes in the traffic
|
|
| |
|
Total Score
© Vincent Cumberworth 2005 |
