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 determine how they would have affected you.

    Use the following scale to 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

  • _______ Sitting and reading

  • _______ Watching TV

  • _______ Sitting inactively in a public place (e.g. a theater or a 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 traffic

Total: _____
If your total is greater than 9, ask your doctor if you might have a sleep disorder.

Additional Resources

Fact sheet: Snoring and Sleep Apnea
Fact sheet: Pediatric Sleep Apnea
Treatment Options for Adults with Snoring
Fact sheet: Continuous Positive Airway Pressure (CPAP)
Oral Appliances
National Sleep Foundation
American Sleep Apnea Association
American Academy of Sleep Medicine

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