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CTA Curve

Screening questionnaire of Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently try to work out how they would have affected you.
1

Sitting and reading

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
2

Watching television

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
3

Sitting inactive in a public place (e.g. a theater or meeting)

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
4

As a passenger in a car for an hour without a break

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
5

Lying down to rest in the afternoon when circumstances permit

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
6

Sitting and talking to someone

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
7

Sitting quietly after a lunch without alcohol

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
8

In a car, while stopped for a few minutes in the traffic

Would never doze
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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