PEDIATRIC DAYTIME SLEEPINESS SCALE (PDSS) Please answer the following questions as honestly as you can by entering one answer only using the following guide:1. How often do you fall asleep or get drowsy during class periods? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 2. How often do you get sleepy or drowsy while doing your homework? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 3. Are you usually alert most of the day? (note: number assignment change) Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 4. How often are you ever tired ad grumpy during the day? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 5. How often do you have trouble getting out of bed in the morning? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 6. How often do you fall back to sleep after being awakened in the morning? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 7. How often do you need someone to awaken you in the morning? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 8. How often do you think that you need more sleep? Always = 4 Frequently = 3 Sometimes = 2 Seldom = 1 Never = 0 Patient Name First Last Signature
