Epworth Sleepiness Scale
Mark your score using the following values:
0 = NEVER 1 = SLIGHT CHANCE
2 = MODERATE 3 = VERY LIKELY
How likely are you to doze off in these situations?
___ Sitting and Reading
___ Watching TV
___ Sitting in a public place
___ Riding in a car, train, or plane
___ Lying down in the afternoon
___ Sitting and Talking
___ Sitting quietly after drinking alcohol
___ In a car stopped for traffic
A score of eight or higher indicates you may have a sleep disorder.
The Snore Score
___ How often are you told you snore?
___ Does your snoring affect your bed partner?
___ Does your snoring affect others in the house?
A score of two or higher indicates your snoring may be related to a sleep disorder.
Clifton Center For Sleep Disorders
6 Brighton Road, Suite 106, Clifton, NJ 07012
Phone: 973.272.6933 Fax: 973.272.6935