If you suspect that you have a sleep-related breathing disorder, please complete this strictly confidential sleep assessment form. It includes the Epworth Sleepiness Scale, a widely used tool to assess daytime sleepiness, as well as a series of questions to determine the nature of your sleep problem. The results will automatically tabulate and determine if you are at risk for obstructive sleep apnea (OSA).

Disclaimer: SleepQuest Inc presents this assessment as an educational service. SleepQuest does not dispense individual medical advice and completing this assessment is not a substitute for a physical examination by a physician. Though our evaluation of your assessment may indicate the possibility of a sleep-related breathing disorder, it does not constitute a diagnosis and should not be used in place of consulting a physician. Regardless of our evaluation of your assessment, the services of a physician should be sought whenever you believe you need medical advice or treatment.

 Yes, I have read the foregoing disclaimer and understand the purpose and limitations of the service provided by SleepQuest.

Begin Free Sleep Questionnaire