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Hypersomnolence survey

This resource has been kindly shared by the Boston Children’s Hospital, and Harvard Medical School Teaching Hospital.

These questions are about your symptoms of possible sleep problems. Think about your last week while you were in school when choosing your answers.

Download the full PDF Hypersomnolence survey here.

Filling out the survey

Check ‘Often’ if the symptom happens 3 times or more per week. Check ‘Sometimes’ if the symptoms happens 1 to 3 times per week. Check ‘Never’ if you do not have the symptom.

Check ‘Do not know (DNK)’ if you are not sure if you have the symptom.

Counting up your points

Add up your total points in each column.

‘Often’ is 3 points.

‘Sometimes’ is 2 points.

‘Never’ is 1 point.

For ‘Do not know’ answers, ask your provider to explain symptom if you are unsure how to respond.

Your total score (questions 1 to 14):

Your sleepiness subscale score (questions 1 to 5, and question 12):

Interpreting your score

This screening questionnaire is not a substitute for medical advice and should not be used to diagnose or treat a health condition.

A total score of more than 24 suggests a high risk for narcolepsy or idiopathic hypersomnia. Please take this form to your healthcare provider or sleep medicine specialise to discuss your sleep related concerns.

Download the full PDF Hypersomnolence survey here.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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