Goodlettsville Dental Services

Sleep Apnea Self Test

Self Test

The only way to be sure if you have obstructive sleep apnea is to have a sleep test either at home from a qualified sleep physician or in a hospital sleep center, but a score of 9 or above on this test is an indication that you should see your doctor.

Please feel free to print this test, fill it out and take with you to your physician.

The Epworth Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations?

Choose the most appropriate number for each situation:

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Activity	Score
Sitting and Reading
Watching TV
Sitting, inactive in a public place (theater, meeting, etc.)
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 lunch without alcohol
In a car, while stopped for a few minutes in traffic
Total

A score of 9 or above indicates you may be having a problem with daytime sleepiness but below 9 does not necessarily mean that you don’t have a problem. See your healthcare professional for advice if you snore, have been told that you awake gasping for breath or if you are sleepy during the day.

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