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Sleep Apnea Test


    EPWORTH SLEEPINESS SCALE

    How likely are you to doze off or fall asleep and not just feel tired in the following situations? EVEN if you have not been in one of these situations lately, imagine what effect it would have had on you.

    Choose the most appropriate response from the following:

    • 0 = No risk of falling asleep
    • 1 = Low risk of falling asleep
    • 2 = Moderate risk of falling asleep
    • 3 = High risk of falling asleep
    Questions 0 1 2 3
    1.Reading in sitting position 0 1 2 3
    2.Watching television 0 1 2 3
    3.Sitting idle in a public place (theater, meeting, etc). 0 1 2 3
    4.Sitting as a passenger in a vehicle for a journey of one hour or more. 0 1 2 3
    5.Lie down in the afternoon when circumstances permit. 0 1 2 3
    6.Sitting while talking with someone. 0 1 2 3
    7.Sitting quietly after a meal without alcoholic drink. 0 1 2 3
    8.In a car stopped for a few minutes at a traffic light or in traffic. 0 1 2 3
    RESULTS: TOTAL:
    STOP-BANG RATING MODEL (SLEEP APNEA SYNDROME SCREENING)
    S(SNORING) Do you snore loudly (louder than when you speak or loud enough to be heard through closed doors)? YES
    Yes    		 NO
    No
    T(TIREDNESS) Do you often feel tired, exhausted or sleepy during the day? YES
    Yes    		 NO
    No
    O(OBSERVATION) Has anyone ever noticed that you stopped breathing in your sleep? YES
    Yes    		 NO
    No
    P(BLOOD PRESSURE) Have you followed or are you undergoing treatment for high blood pressure? YES
    Yes    		 NO
    No
    B(BMI) BMI greater than 35 kg / m2? YES
    Yes    		 NO
    No
    A(AGE) Age over 50? YES
    Yes    		 NO
    No
    N(NECK CIRCUMFERENCE) Circumference at 40cm (16in)? YES
    Yes    		 NO
    No
    G(GENDER) Male? YES
    Yes    		 NO
    No
    RESULTS :

    First Name

    Last Name

    Email