Epworth Sleepiness Scale

Pulmonology
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Epworth Sleepiness Scale
[select name="Q1" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are sitting and reading
[select name="Q2" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are watching television
[select name="Q3" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are sitting inactive at a public place (e.g., in a theater, during a meeting)
[select name="Q4" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are a passenger in a car riding for an hour without breaks
[select name="Q5" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are lying down in the afternoon when circumstances permit
[select name="Q6" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are sitting and talking to someone
[select name="Q7" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are sitting quietly after lunch without alcohol
[select name="Q8" value="No chance (0 points)=0|Slight chance (1 point)=1|Moderate chance (2 points)=2|High chance (3 points)=3"] <-- Rate the chance you will doze off while you are in a car while stopped for a few minutes in traffic
[calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)" memo="score"] out of 24 points --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8);score>15?'severe sleepiness - further evaluation recommended for significant daytime sleepiness':score>11?'moderate sleepiness - further evaluation recommended for significant daytime sleepiness':score>7?'mild sleepiness':'normal daytime alertness'" memo="interpretation"]
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: <a href="http://www.ncbi.nlm.nih.gov/pubmed/1798888" target="_blank">Johns (1991) Sleep 14(6): 540-5</a>, <a href="http://www.aafp.org/afp/2009/0301/p391.html" target="_blank">Pagel (2009) Am Fam Physician 79(5):391-396</a>, <a href="http://www.fpnotebook.com/psych/exam/EpwrthSlpnsScl.htm" target="_blank">FP Notebook Page</a>[/html][/conditional]
Epworth Sleepiness Scale
<-- Rate the chance you will doze off while you are sitting and reading
<-- Rate the chance you will doze off while you are watching television
<-- Rate the chance you will doze off while you are sitting inactive at a public place (e.g., in a theater, during a meeting)
<-- Rate the chance you will doze off while you are a passenger in a car riding for an hour without breaks
<-- Rate the chance you will doze off while you are lying down in the afternoon when circumstances permit
<-- Rate the chance you will doze off while you are sitting and talking to someone
<-- Rate the chance you will doze off while you are sitting quietly after lunch without alcohol
<-- Rate the chance you will doze off while you are in a car while stopped for a few minutes in traffic
scorescore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8) out of 24 points --> interpretationscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8);score>15?'severe sleepiness - further evaluation recommended for significant daytime sleepiness':score>11?'moderate sleepiness - further evaluation recommended for significant daytime sleepiness':score>7?'mild sleepiness':'normal daytime alertness'

display/hide references
Result - Copy and paste this output:

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