Please select the appropriate number for each situation:
0 = would never doze or sleep
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping
Situation
0
1
2
3
Sitting and reading
Watching TV
Sitting inactive in a public place
Being a passenger in a motor vehicle for an hour or more
Lying down in the afternoon
Sitting and talking to someone
Sitting quietly after lunch (no alcohol)
Stopped for a few minutes in traffic
Total score
Scoring results:
10+ indicates pathological daytime sleepiness
In order to ensure accurate insurance predetermination, do not underestimate your scores. If you scored 10 or above, you should be evaluated for obstructive sleep apnea as soon as possible. Contact our office for assistance.
