During a normal day how likely would you be to fall asleep or
doze? (Not just tired) Use the scale to choose the number that fits each case.
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
Situation
Chance of Dozing
*If your total score is above 10, ask your physician about possible sleep related problems.