Plano Dental Sleep Medicine
The only way to be sure if you have obstructive sleep apnea is to have a sleep test either at home from a qualified sleep physician or in a hospital sleep center.
Please feel free to print these tests (requires free Adobe Reader®), fill them out and take them with you to your physician.
The Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations?
Choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
| Activity | Score |
| Sitting and Reading | _____ |
| Watching TV | _____ |
| Sitting, inactive in a public place (theater, meeting, etc.) | _____ |
| 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 | _____ |
| Total | _____ |
| Observed Behavior | Score |
| Loud, irritating snoring | _____ |
| Choking or gasping for air | _____ |
| Pauses in breathing | _____ |
| Twitching / kicking of arms or legs | _____ |
| Snoring requiring separate bedrooms | _____ |
| Falling asleep inappropriately (example: while driving or at meetings) | _____ |
| Total | _____ |