Forms
Prepare for Your Sleep Study:
Download Patient Forms Here
The Epworth Sleepiness Test
Once completed, tally your points, if your total score is more than 5 you should be evaluated by a sleep specialist to find out if you have a sleep disorder.
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
| SITUATION | CHANCE OF DOZING |
|---|---|
| Sitting and reading | 0 1 2 3 |
| Watching television | 0 1 2 3 |
| Sitting inactive in public | 0 1 2 3 |
| Passenger in car for an hour | 0 1 2 3 |
| Lying down in afternoon | 0 1 2 3 |
| Sitting or talking to someone | 0 1 2 3 |
| Sitting after lunch (no alcohol) | 0 1 2 3 |
| In a car stopped in traffic | 0 1 2 3 |
Snoring plus neck circumference greater than 17 inches indicates high probability of sleep apnea.
Medical problems of hypertension, atrial fibrillation, stroke, depression, fatigue and diabetes are all linked to apnea and poor sleep habits.