Self Assessments

Take these short assessments to find out if you are at risk for sleep apnea.

EPWORTH SLEEPINESS SCALE FORM

Instructions: Be as truthful as possible. Read the situation and then enter a score based on this scale: 0-would never doze, 1-slight chance of dozing, 2-moderate chance of dozing, 3-high chance of dozing.

___1. Sitting and Reading           

___2. Watching Television

___3. Sitting inactive in a public place, for example, a theatre or movie

___4. As a passenger in a car for an hour without a break

___5. Lying down to rest in the afternoon

___6. Sitting and talking to someone

___7. Sitting quietly after lunch when you’ve had no alcohol

___8. In a car while stopped in traffic

A score of 10 or more indicates a possible sleep disorder.

THORNTON SNORING SCALE

If you snore, it doesn’t only affect you, depriving you of comfortable rest. It also affects others. The Thornton Snoring Scale can help you determine how your snoring may be influencing the people around you. Choose the most appropriate number for each situation. (Go to question #4 if you have no bed partner).

0-Never, 1-Infrequently (1 night/week), 2-Frequently (2-3 nights/week), 3-Most of the time (4+ nights)

___1. My snoring affects my relationship with my partner.

___2. My snoring causes my partner to be irritable or tired.

___3. My snoring requires us to sleep in separate rooms.

___4. My snoring is loud.

___5. My snoring affects people when I am sleeping away from home.

If score is 5 or higher, patient should seek medical advice.