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Sleep Wellness Quiz
Take this short quiz to determine if your sleep health may be at-risk, and how you can better improve your overall-wellness. This quiz won't take you more than 3 minutes.
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1
Name
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By entering your details and participating in this quiz, you agree to your personal information managed in accordance with the
Green Cross Health Privacy Policy
First Name
Last Name
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2
Which is the closest Unichem or Life Pharmacy to you?
The quiz will start when you click 'next'.
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NORTH ISLAND
Life Pharmacy Albany
Life Pharmacy Bayfair
Life Pharmacy Glenfield
Life Pharmacy Johnsonville
Life Pharmacy Masterton
Life Pharmacy Newmarket
Life Pharmacy Sylvia Park
Unichem Greenmeadows Pharmacy
Unichem Russel Street
Unichem Hurst and Taylor Pharmacy
Unichem Orrs Pharmacy Kaikohe
Unichem Rototuna Pharmacy
Unichem The Palms Pharmacy
Life Pharmacy Howick Village
Unichem Apollo Pharmacy
Life Pharmacy Queensgate
Unichem Richardson Road Pharmacy
Unichem Walls and Roche Pharmacy
UC Waiuku
UC Cambridge Family Health
SOUTH ISLAND
Life Pharmacy Dunedin
Life Pharmacy Northlands
Life Pharmacy The Palms
Unichem Medical Corner Pharmacy
Unichem Redwoodtown Pharmacy
Unichem Rolleston Village Pharmacy
Unichem Remarkables Pharmacy
Unichem Waikiwi Pharmacy
Please Select
Please Select
NORTH ISLAND
Life Pharmacy Albany
Life Pharmacy Bayfair
Life Pharmacy Glenfield
Life Pharmacy Johnsonville
Life Pharmacy Masterton
Life Pharmacy Newmarket
Life Pharmacy Sylvia Park
Unichem Greenmeadows Pharmacy
Unichem Russel Street
Unichem Hurst and Taylor Pharmacy
Unichem Orrs Pharmacy Kaikohe
Unichem Rototuna Pharmacy
Unichem The Palms Pharmacy
Life Pharmacy Howick Village
Unichem Apollo Pharmacy
Life Pharmacy Queensgate
Unichem Richardson Road Pharmacy
Unichem Walls and Roche Pharmacy
UC Waiuku
UC Cambridge Family Health
SOUTH ISLAND
Life Pharmacy Dunedin
Life Pharmacy Northlands
Life Pharmacy The Palms
Unichem Medical Corner Pharmacy
Unichem Redwoodtown Pharmacy
Unichem Rolleston Village Pharmacy
Unichem Remarkables Pharmacy
Unichem Waikiwi Pharmacy
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3
1. How likely are you to nod off or fall asleep while sitting and reading?
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Not at all
Slight Chance
Moderate Chance
High Chance
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2. How likely are you to doze off or fall asleep while watching television?
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Not at all
Slight Chance
Moderate Chance
High Chance
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5
3. How likely are you to doze off or fall asleep while sitting inactive in a public place (e.g. a theatre/meeting)?
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Not at all
Slight Chance
Moderate Chance
High Chance
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4. How likely are you to doze off or fall asleep as a passenger in a car for an hour with no break?
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Not at all
Slight Chance
Moderate Chance
High Chance
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7
5. How likely are you to doze off or fall asleep while lying down in the afternoon (when possible)?
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Slight Chance
Moderate Chance
High Chance
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8
6. How likely are you to doze off or fall asleep while sitting and talking to someone?
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Slight Chance
Moderate Chance
High Chance
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7. How likely are you to doze off or fall asleep while sitting quietly after lunch without alcohol?
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Not at all
Slight Chance
Moderate Chance
High Chance
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10
8. How likely are you to doze off or fall asleep in a car, while stopped for a few minutes in traffic?
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Not at all
Slight Chance
Moderate Chance
High Chance
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11
9. Do you snore loudly (loud enough to be heard through closed doors)?
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YES
NO
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12
10. Do you often feel tired, fatigued or sleepy during the daytime falling asleep (while driving or talking to someone)?
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YES
NO
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11. Has anyone observed you stop breathing or choking/gasping during your sleep?
*
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YES
NO
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14
12. Do you have or are you being treated for high blood pressure?
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YES
NO
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15
13. Is your Body Mass Index more than 35 kg/m2?
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Body Mass Index = Weight (kg) / Height2 (m)
YES
NO
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16
14. Are you older than 50?
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YES
NO
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15. Do you have a large size neck?
*
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For male, is your shirt collar 17 inches / 43 cm or larger? For female, is your shirt collar 16 inches / 41 cm or larger? (measured around the Adam’s apple)
YES
NO
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18
16. Are you male?
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YES
NO
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19
Part 1 Score
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20
Part 2 Score
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21
Our screening tool indicates that you are unlikely to suffer from sleep apnoea.
On the next page, click 'submit' to be redirected back to lifepharmacy.co.nz
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22
Our screening tool indicates that you might be at risk of sleep apnoea.
On the next page, click 'submit' to find a Life or Unichem Pharmacy offering sleep consultation services and receive a $50 voucher for your home sleep test.
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23
Fill in your e-mail address below to receive $50 off your home sleep test.
Click 'submit' to receive your voucher, a copy of your answers and where you can find a Life or Unichem Pharmacy offering sleep consultation services.
E-Mail Address
Please enter your phone number if you would like to receive a follow-up over the phone.
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