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Mann Cottage NHS GP Surgery in Moreton-in-Marsh

Epworth sleepiness review

Section

Situation / Chance of Dozing

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 theater 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

Your Epworth Sleepiness Scale score:

I confirm that the information provided is accurate to the best of my knowledge.

If you are human, leave this field blank.

Four Shires Medical Centre
Stow Road
Moreton-in-Marsh
Gloucestershire
GL56 0DS

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01608 650764

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