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Sleep Assessment
We've got 8 simple questions for you to answer. Just pick the one that you think best describes you. Once you're done, we'll send you an email with your score straight away on the submission. Let's get started!
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1
Your First Name
*
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2
Your Last Name
*
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3
Your Phone Number
Please enter a valid phone number.
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4
Your Email
*
This field is required.
Enter your email so we can send this report to you.
example@example.com
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5
Sitting and reading
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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6
Watching TV
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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7
Sitting inactive in a public place (e.g a theater or a meeting)
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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8
As a passenger in a car for an hour without a break
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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9
Lying down to rest in the afternoon when circumstances permit
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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10
Sitting and talking to someone
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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11
Sitting quietly after a lunch without alcohol
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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12
In a car, while stopped for a few minutes in traffic
*
This field is required.
No chance of dozing
Slight chance of dozing
Moderate chance of dozing
High chance of dozing
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13
Your Total Score
If you have a score above 10, are not waking up feeling refreshed and rested, or you or your sleep partner identify that you are snoring or stop breathing in your sleep, you should consider a proper evaluation by a trained professional. Please check your email inbox for a more detailed explanation of your results and information about Sleep Disturbances and Sleep Apnoea!
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