Take the Epworth Sleep Apnea Assessment

There are a variety of methods for helping patients determine whether or not they’re likely to be suffering from sleep apnea. At Seahurst Park Dentist, David Thomas, DDS and his skilled team rely on a quick, simple assessment – the Epworth Sleepiness Scale. This is a great screening tool to help patients understand their likelihood of suffering from this common sleep disorder.

Complete the Epworth questionnaire below. We’ll be back in touch with you within 24 hours to let you know whether or not we believe you’re at high risk for 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