Jim's Home Health - Sleep Apnea Quiz - ic00046082

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The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness.

Do you wake up exhausted? Does your partner complain that you snore at night? If you answered yes, these are potential signs of Sleep Apnea. Take our quie and our Respiratory Staff can explain the results.

Please fill out your contact information below.

Name*

First Name

Last Name

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Epworth Sleepiness Scale

Chance of dozing or sleeping in the following situations

Use the following scale to choose the most appropriate number for each situation:

Would never doze or sleep
slight chance of dozing or sleeping.
moderate chance of dozing or sleeping
high chance of dozing or sleeping

Sitting and reading

Watching TV

Sitting inactive in a public place

Being a passenger in a motor vehicle for an hour or more

Lying down in the afternoon

Sitting and talking to someone

Setting quietly after lunch (no alcohol)

Stopped for a few minutes in traffic

Total Score

This is your Epworth Score