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Epworth Sleepiness Questionnaire for Seniors

How likely are you to doze off or to fall asleep in the following situations, in contrast to just feeling tired? This refers to your usual way of life in recent times. Use the following scale to choose the most appropriate number for each situation.

0 - would never doze
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  
As a passenger in a car for an hour  
Lying down to rest in the afternoon  
Sitting and talking to someone  
Sitting quietly after a lunch without alcohol  
In a car while stopped for a few minutes  
Total /24

Medical Questionnaire Geriatric Depression Scale
CAGE ADAM (men only)




  

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