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 Sleep  Holistic-online.com

Sleepiness Assessment

How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling 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 often they would have affected you. Use the following to choose the most appropriate answer for each situation:
would never doze 
slight chance of dozing 
moderate chance of dozing 
high chance of dozing

You can only select one out of the four. To select an item, click on the button to the left of the selection. If you want to choose another selection, click on that button. (The latest selection only counts.)

After you complete the questionnaire, click on the button marked Done to evaluate your sleepiness scale..

Sleepiness Assessment Questionnaire

  1. How likely are you to doze off or fall asleep while sitting and reading?
    would never doze
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  2. How likely are you to doze off or fall asleep while watching TV?
    would never doze 
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  3. How likely are you to doze off or fall asleep while sitting, inactive in a public place (eg, a theater or a meeting)?
    would never doze 
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  4. How likely are you to doze off or fall asleep while traveling as a passenger in a car for one hour without a break?
    would never doze 
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  5. How likely are you to doze off or fall asleep when 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
  6. How likely are you to doze off or fall asleep while sitting and talking to someone?
    would never doze 
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  7. How likely are you to doze off or fall asleep while sitting quietly after a lunch without alcohol?
    would never doze 
    slight chance of dozing 
    moderate chance of dozing 
    high chance of dozing
  8. How likely are you to doze off or fall asleep 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

<- Click on this button after you have completed the questionnaire.

Go To Sleep Home

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