Sleep assessment quiz

Sleep assessment quiz

Epworth sleepiness scale (ESS)

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.

How likely are you to doze off in these situation Never Slight Moderate High
Sitting and reading
Watching television
Sitting inactive in a public place (e.g. a theatre or meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in the traffic
Total score: 0

Please select to complete STOP-BANG Questionnaire or OSA 50 Screening Questionnaire

Please answer Yes or No to the following questions Yes No
Do you snore loudly?
Do you often feel tired, fatigued, or sleepy during the daytime?
Has anyone observed you stop breathing during your sleep?
Do you have or are you being treated for high blood pressure?
Are you obese/very overweight - BMI more than 35 kg/m²?
Age over 50 years old?
Neck circumference greater than: 43cm (male) or 41cm (female)
Are you male?
Total score: 0
Please answer Yes or No to the following questions Yes No
Waist circumference Male > 120cm or Females > 88cm
Has your snoring ever bothered other people?
Has anyone noticed you stop breathing during your sleep?
Are you aged 50 years or over?
Total score: 0

Assessment result

Epworth Sleepiness Scale (ESS): 0 points

STOP-BANG Questionnaire: N/A

OSA 50 Screening Questionnaire: N/A

Take a sleep assessment quiz to see if you have sleep apnea and qualify for a sleep study.


You can download this form and bring it to your doctor for consultation and sign-off.

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