Stanford Sleepiness Scale (SSS)
7-point self-report scale measuring subjective level of sleepiness at a given moment. Developed at Stanford. Used in sleep research and clinical assessment. Score 1 = feeling active/alert; score 7 = fighting sleep.
Score interpretation
SSS 1–3 — normal alertness range
→ No immediate action required; continue activities; note if score is consistently elevated on serial testing
SSS 4–5 — significant sleepiness; below optimal alertness
→ Assess sleep quality (total sleep time, sleep latency); screen for sleep disorders (OSA — Epworth, STOP-BANG); review medications; caffeine use; advise against driving or hazardous tasks
SSS 6–7 — severe sleepiness; sleep onset imminent
→ Do not drive or operate machinery; urgent sleep medicine referral; assess for narcolepsy, severe OSA, insufficient sleep syndrome; polysomnography if indicated; safety assessment
Interpretation bands for the Stanford Sleepiness. Apply clinical judgement and local guidance.
References
- Hoddes E et al. Quantification of sleepiness: a new approach. Psychophysiology. 1973;10(4):431–436.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.