National Sleep Foundation

Chapter 1: Normal Sleep

Sleep Assessment & Evaluation: Primary Care Tools

The best way to figure out what is wrong with your sleep is to start with your doctor. There are many easy-to-use tools to help individuals and primary care providers evaluate a person’s sleep. These include instruments and scales like the National Sleep Foundation’s Sleepiness Test, the Insomnia Severity Index, the Epworth Sleepiness Scale, and the STOP BANG Screening Questionnaire, described below. In addition, keeping a sleep diary for two to three weeks can provide valuable information about sleep patterns and practices (the NSF’s Sleep Diary is available here:

National Sleep Foundation’s Sleepiness Test

The National Sleep Foundation’s Sleepiness Test collects information about sleep patterns in the last two weeks, to assess whether a person is more or less sleepy than the general population. Doctors often use tests like this to assess their patients’ sleepiness levels.  People who are rated as “very sleepy” should speak to their primary care physician about their sleep.117

Insomnia Severity Index™  

Most people know what it feels like to be in bed, wide awake, staring at the ceiling and wishing for sleep — such insomnia can happen when a person travels and experiences jet lag, or during times of anxiety and stress. Tools like the seven-question Insomnia Severity Index can help tell if a person is experiencing normal, temporary sleep problems, or has a more serious form of insomnia that requires treatment.118  Using the Index, people rate their experience of symptoms such as difficulty falling or staying asleep, feeling fatigued, having problems at home or at work, and having difficulty with concentration or mood. A higher score indicates more severe insomnia. 

Epworth Sleepiness Scale (ESS)

The Epworth Sleepiness Scale measures people’s daytime sleepiness.119 The scale describes eight situations and asks people to rate the chances of their falling asleep if they were in these situations. The higher a person scores, the higher their level of daytime sleepiness is assessed to be. 

STOP BANG Screening Questionnaire

The STOP BANG Screening questionnaire assesses people for obstructive sleep apnea (OSA). The acronym spells out the tool’s eight questions, which assess the person’s: Snoring, Tiredness, Observation of stopping breathing, high blood Pressure, Body mass index, Age, Neck size, and Gender. Based on age and Body Mass Index (BMI), a higher score indicates a greater likelihood the person has OSA.120

National Sleep Foundation’s Sleep Diary

The National Sleep Foundation’s Sleep Diary is easy to use and takes just a few minutes each day to complete. It asks about things that can help, or hinder, a good night’s sleep, including the person’s bedroom environment, sleep habits, and caffeine consumption. Completing the Sleep Diary every morning and evening for a week or more captures valuable information that assists individuals and their health care providers to identify patterns and practices that foster — or hinder — a good night’s sleep.121 The NSF’s Sleep Diary is available here:


117. National Sleep Foundation, Sleepiness Test, Arlington, VA: NSF, no date.  Available at:

118. Wilkinson K, Marcu S, and Shapiro CM, STOP, THAT and One Hundred Other Sleep Scales, New York: Springer, 2012.

119. National Sleep Foundation, Fatigue and Excessive Sleepiness, Arlington, VA: NSF, no date.  Available at:

120 Toronto Western Hospital, University Health Network, The Official STOP BANG Questionnaire Website, Toronto: University of Toronto, 2012. Available at:

121. National Sleep Foundation, Sleep Diary, Arlington, VA: NSF, no date.  Available at: