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Questions About Sleep Apnea

To help you get a better understanding of sleep apnea, and understand what questions we might ask, we have put together a simple questionnaire for you. In this survey, you will see a series of questions about how likely you are to doze off during the day. Take a look:

How likely are you to doze off or fall asleep in the following situations? You should rate your chances of dozing off, not just feeling tired.

  1. Sitting and reading
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. Watching television
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. Sitting inactive in a public space (i.e. a theater or a meeting)
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. As a passenger in a car for an hour without a break
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. Lying down to rest in the afternoon when circumstances permit
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. Sitting and talking to someone
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. Sitting quietly after a lunch without alcohol
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing
  1. In a car, while stopped for a few minutes in traffic
    1. No chance of dozing
    2. Slight chance of dozing
    3. Moderate chance of dozing
    4. High chance of dozing

If you experience a high chance of dozing in most of these situations you might be suffering from sleep apnea. Please contact our office for more information on sleep apnea and how we can help you get a better night’s sleep.