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Sixpenny Handley & Chalke Valley Practice NHS GP Surgery in Dorset and Wiltshire

Epworth sleepiness review

Epworth Sleepiness Scale

How likely are you to doze off or fall asleep during the following situations, in contrast to just feeling tired?

Sitting and Reading: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Watching TV: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting, inactive in a public place (e.g. a theatre or a meeting): *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

As a passenger in a car for an hour without a break: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Lying down to rest in the afternoon when circumstances permit: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting and talking to someone: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

Sitting quietly after lunch without alcohol: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

In a car, while stopped for a few minutes in traffic: *

Would never doze

Slight chance of dozing

Moderate chance of dozing

High chance of dozing

If you are human, leave this field blank.

The Sixpenny Handley Surgery
Dean Lane
Sixpenny Handley
Dorset
SP5 5PA

Get directions

01725 552500

The Broad Chalke Practice
Doves Meadow
Wiltshire
SP5 5EL

Get directions

01722 780282

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