Sleep Questionnaire

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The Epworth Sleepiness Scale helps you determine if you possibly suffer from a sleep disorder and its severity. This scale was developed in 1991 by Dr. Murray Johns right here in Melbourne.

Our sleep questionnaire assesses your sleepiness along with some common risks and symptoms to determine your likelihood of a sleep related issue. Complete the questionnaire now and find out if you require a diagnostic sleep study.

How likely are you to doze off or fall asleep:
Sitting and Reading?*

How likely are you to doze off or fall asleep:
Watching TV?*

How likely are you to doze off or fall asleep:
Sitting, inactive in a public place? (e.g. a theatre or a meeting)*

How likely are you to doze off or fall asleep:
As a passenger in a car for an hour without a break?*

How likely are you to doze off or fall asleep:
Lying down to rest in the afternoon when circumstances permit?*

How likely are you to doze off or fall asleep:
Sitting and talking to someone?*

How likely are you to doze off or fall asleep:
Sitting quietly after a lunch without alcohol?*

How likely are you to doze off or fall asleep:
In a car, while stopped for a few minutes in the traffic?*

Is your waist circumference greater than
102cm (male) or 88cm (female) at the belly button?*

Has your snoring ever bothered other people?*

Has anyone noticed that you stop breathing during your sleep?*

Are you aged 50 or over?*

Your Sleep Result

Epworth
Sleepiness Scale
0/24

OSA-50 Sleep Apnea
Risk Screening
0/10

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Email Address*
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Sleep Test Enquiry