Epworth Self-Survey

Epworth Sleepiness Score Survey

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

Situation0123
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.

WE ARE OPEN TO SERVE YOU!
Here is how we are keeping you safe, particularly during the COVID-19 viral outbreak.
OUR SAFETY PROTOCOLS MEET OR EXCEED ALL LOCAL, STATE, AND FEDERAL REQUIREMENTS

 

Pre and day-of appointment screening questions to determine infection risk.

Hand sanitizing gel and masks for all patients immediately upon entering.

“No touch” infrared forehead thermometer check before treatment.

Social distancing protocol and ‘sneeze guard’ shields at the reception desk.

Medical-grade HEPA filtration units for sanitation of the air we breathe in the office.

• PPE for clinical staff includes a gown, gloves, mask, eye protection and a face shield.

Disposable sterile single-use clinical instruments are utilized wherever possible.

Reusable instruments are packaged and sterilized in an autoclave before being returned to service. Delicate reusables are soaked overnight in a hospital-grade sterilant solution.

Our autoclave is tested AT LEAST weekly by an independent microbiology lab to confirm that our autoclave is working properly.

All exposed patient chair and work surfaces are sprayed and wiped down with a hospital-grade disinfecting solution that kills viruses and bacteria between patients.

High-touch areas like computer keyboards, mice, headrests and chair arms are covered with single-use disposable barriers that are replaced after each patient.

• New Mandibular Advancement Devices are disinfected twice: by the lab after fabrication and again in our office before delivery to a patient.

 

Thank you for entrusting us to keep you safe while we help you get a more restful night’s sleep. After all, getting quality sleep is one of the most important things you need to stay healthy!