Sleep Consultation Questionnaire
Sleep Habits
Sleep Problems´╗┐
When sleeping how often do you: (select one)
Epworth Sleepiness Scale
Instructions: Be as truthful as posible. Rate your sleepiness on a scale of 0-3 and fill in your responses for the situations. Total all of your entries and enter the total in the final box.

0 = Would never doze.
1 = Slight chance of dozing.
2 = Moderate chance of dozing
3 = High chance of dozing
STOP BANG Questionnaire´╗┐