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Do I have Sleep Apnea? A 2-minute self-test questionnaire.

Have you ever doze off or fall asleep in the following activities?

0 = Never happened

1 = Slight chance of dozing

2 = Moderate chance of dozing

3 = High chance of dozing

□ 1. Sitting and reading
□ 2. Watching TV
□ 3. Sitting inactive in a public space (e.g. a theatre or a meeting)
□ 4. As a passenger
□ 5. Lying down to rest when circumstances permit
□ 6. Sitting and talking to someone
□ 7. Sitting quietly after a lunch without alcoholic drinks
□ 8. In a car, while stopped for a few minutes in traffic

= Total Score

Self-test analysis
(Epworth Sleepiness Scale Key)

0-6: Your need for sleep is normal.
7-8: Your need for sleep is general.
9 or above: Your need for sleep is serious, please consult your doctor and arrange a Sleep Study.

This questionnaire is just for reference. If you want a more precise analysis, please consult your doctor.



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