The Epworth Sleepiness Test is commonly used to begin the screening process for patients with potential sleep disturbance.  Take the survey below to begin the process of determining if you or a loved is having a sleeping issue.  This is a free survey!

How likely are you to fall asleep doing the following activities?

Do you occasionally snore? *
Would your bed partner consider your snoring to be louder than a person talking? *
Does your snoring occur almost every night? *
Is your snoring bothersome to your bed partner?
Do you feel that in some way your sleep is not refreshing or restful? *
Do you wake up at night or in the mornings with headaches? *
Do you experience fatigue during the day and have difficulty staying awake? *
Do you have trouble remembering things or paying attention during the day? *
Do you have high blood pressure? *
If yes, fill it in the field below
Have you been previously diagnosed with sleep apnea? *
(Approx month/year)
Were you put on CPAP therapy for treatment?
Skip if you have never been diagnosed with sleep apnea
If yes, are you still using your CPAP?
Name *
Name