University Services
Sleep Diagnostic and Treatment Centers

Do you have a sleep problem?

Rate the chance that you would doze off or fall asleep during different routine situations, even if you have not done some of these activities recently. Consider how the activity would affect you.

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

0 1 2 3 Sitting or Reading Watching TV Sitting inactive in a public place (theater, meeting, etc) As a passenger in a car for an hour without a break Lying down to rest in the afternoon when circumstances permit Sitting and talking to someone Sitting quietly after lunch without alcohol In a car while stopped for a few minutes in traffic