Patient & Epworth Inputs
Epworth Sleepiness Scale (0–3 each)
Sitting and reading
0
1
2
3
Watching TV
0
1
2
3
Sitting inactive in a public place (e.g., theater, meeting)
0
1
2
3
As a passenger in a car for an hour without a break
0
1
2
3
Lying down to rest in the afternoon when circumstances permit
0
1
2
3
Sitting and talking to someone
0
1
2
3
Sitting quietly after lunch without alcohol
0
1
2
3
In a car, while stopped for a few minutes in traffic
0
1
2
3
Severity, Therapy & Notes
Epworth Sleepiness Scale
Score —
Band —
Epworth Score
—
Epworth Band
—
Clinical Note
—
Suggested Therapy Pathway
Please consult your healthcare provider to discuss your Epworth Sleepiness Scale score,
daytime symptoms, and whether additional evaluation — such as sleep study or OSA
screening — may be appropriate. A qualified clinician can help determine the best
course of action based on your overall health and level of sleepiness.
Sleep Study & OSA Data
Age (years)
—
BMI (kg/m²)
—
Apnea-Hypopnea Index (AHI)
Lowest Oxygen Level (O₂ Nadir %)
Clinician & Patient Notes
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