The following self-evaluation test will help you determine if you have symptoms that may need medical attention.
YesNo
Do you awaken from sleep short of breath?
Do you snore loudly enough that others complain?
Do you fall asleep during the day while driving, when crying or laughing?
Do you have trouble at work because of sleepiness?
Do you have the feeling of being paralyzed when waking or falling asleep?
Do you have morning jaw pain or headaches?
Do you frequently get heartburn in the middle of the night?
Do you awaken not feeling rested or refreshed even after eight or ten hours of sleep?
Are you 15 pounds or more overweight?
If you answered yes to one or more of these questions, you may have a sleep disorder.
This test is not a substitute for professional medical diagnosis and treatment management.
If you have any concerns regarding your health, seek professional medical advice.
If you think you may have a sleep disorder and would like to find a physician please search our physician directory or call 1-800-4BAYLOR.
The Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations, 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.
Please print this page and take the completed test to your physician's appointment.
Use the following scale to choose the most appropriate number for each situation:
0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Situation
Chance of Dozing
Sitting and reading
____________
Watching TV
____________
Sitting inactive in a public place
e.g a theater or a 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 traffic
____________
To check your sleepiness score, total the points. Check your total score to see how sleepy you are.
Results
If your score is greater than 6 points then you are sleepy.
If your score is more than 10 points you are very sleepy.
If your score is more than 16 points you are dangerously sleepy.
The Epworth Sleepiness Scale is reproduced with permission from the American Academy of Sleep Medicine.