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. Please feel free to print these tests (requires free Adobe Reader®), fill them out and take them with you to your physician.
Self Tests
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.
The following questions relate to the behavior that you have observed in the patient while he/she is asleep. Use the following scale to choose the most appropriate number for each situation:
0=Never
1=Infrequently (1 night per week)
2=Frequently (2-3 nights per week)
3=Most of the time (4 or more nights per week)
| Observed Behavior |
Score |
| Loud, irritating snoring |
_____ |
| Choking or gasping for air |
_____ |
| Pauses in breathing |
_____ |
| Twitching / kicking of arms or legs |
_____ |
| Snoring requiring separate bedrooms |
_____ |
| Falling asleep inappropriately (example: while driving or at meetings) |
_____ |
|
|
| Total |
_____ |
*A score of 5 or greater indicates symptoms which are affecting the health, safety, or quality of life of the observed person.
