Zeeba Sleep Center Las Vegas
Zeeba Sleep Center
2481 Professional Court
Las Vegas, NV 89128
(702) 242-1562
Zeeba Sleep Center
"for the A to ZZZ's in Healthy Sleep"

Sleep Questionnaires

Clinical Obstructive Sleep Apnea Questionnaire

Based upon the responses to these questions, the risk of a diagnosis of sleep-disorder breathing (obstructive sleep apnea) can be determined.

The Sleep Apnea Quiz

1. Has anyone ever told you that you snore?
2. Does your snoring ever bother anyone?
3. Have you ever been told that you stop breathing while you sleep?
4. Do you awaken gasping, choking, or have shortness of breath?
5. Do you have trouble staying asleep once you fall asleep?
6. Do you have morning or daytime headaches?
7. Do you feel tired or fatigued throughout the day?
8. Have you ever nodded off or fallen asleep while driving?
9. Do you have high blood pressure?
10. Do you have heart disease?
11. Do you have indigestion?
12. Have you had any memory loss?
13. Do you ever awaken with intense anxiety?
14. Do you ever experience depressed feelings?
15. Do you notice a decreased ability to think effectively?
16. Do you ever take naps?
17. Do you notice a decreased sexual interest?
18. Do you smoke?
19. Are you overweight?

Results

Your RISK of a serious sleep-disorder is ...

If VERY HIGH or HIGH

You should seek immediate help for a potentially serious sleep disorder.

If MODERATE

You should seek immediate help for a potentially serious sleep disorder.

If LOW

You still may have a sleep disorder, consult with your doctor to make sure you do not have a sleep disorder.

 

The Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) measures your general level of sleepiness. Your score can help you start a conversation with your doctor about excessive sleepiness (ES) and underlying causes of ES such as treated obstructive sleep apnea (OSA), shift work disorder (SWD), and narcolepsy.

Use the following scale to choose the most appropriate number for each situation:

0 - no chance of dozing
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing

The Epworth Sleepiness Scale (ESS)

Situation Chance of dozing
Sitting and reading
Watching television
Sitting inactive in a public place-for example, a theater or meeting
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon
Sitting and talking to someone
Sitting quietly after lunch without alcohol
In a car, while stopped, for a few minutes in traffic

Results

Your Score:
If your total score is equal to, or greater than 10, or if any individual response is a score of 3, please speak to your physican. Further evaluation of your sleepiness may be necessary to rule out significant sleep disturbances.