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Sleep Self-Evaluation

  • How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired? (This refers to your usual way of life in recent times--even if you haven't done some of these things recently try to work out how they would have affected you.)

    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 of Dozing

  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.
  • Please enter a value between 0 and 3.