Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations? Even if you don’t do some of these things, try to estimate the effect it might have on your level of drowsiness. Use the following scale to choose the most appropriate number for each situation. Give a score of 0-3 for each event. If you score 11 or above, tell your doctor or call us.
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 | _______ |
| Watching T.V. | _______ |
| Sitting, inactive in a public place (meeting or movie). | _______ |
| As a passenger in a car for an hour without a break. | _______ |
| Lying down to rest in the afternoon. | _______ |
| Sitting quietly after lunch without consuming alcohol. | _______ |
| In a car, while stopped for a few minutes in traffic. | _______ |