The Epworth Sleepiness Scale Sleep Apnea Assessment

Do you suspect that you or a loved one may have sleep apnea? Want to get the treatment you need? If so, then the first step you need to take is to complete our short assessment below. The Epworth Sleepiness Scale is currently used by doctors around the world to determine the likelihood that a person has sleep apnea.

The Epworth Sleepiness Scale Assessment

Name

Email Address

Phone Number

Age

Weight

Gender

Have you ever had an evaluation at a sleep center? Yes No

Do you have a CPAP device? Yes No

Have you attempted other therapies to deal with breathing and/or snoring issues? Yes No

If yes, please provide details

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

Sitting and reading

Watching TV

Sitting in a public place (e.g.: theatre, meeting or church)

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

After completing this short quiz, Dr. Buck and our team will be happy to interpret your results. Simply send your name and contact information below to our team, and we’ll contact you within 24 hours to schedule a consultation based on our findings.

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