Sleep Questionnaire

Do you have trouble sleeping?

Would you like a more restful night's sleep?

Complete the following Sleep Self-Assessment Quiz and someone from our office will contact you about your results.

Chance of dozing:

Green cartoon smiley face.
None
Green cartoon happy face.
Slight
Yellow cartoon sad face.
Mild
Orange cartoon frown face.
High
1. Sitting and reading
2. Watching TV
3. Sitting inactive in a public place (e.g., theater or meeting)
4. As a passenger in a car for an hour without a break
5. Lying down to rest in the afternoon when circumstances permit
6. Sitting and talking to someone
7. Sitting quietly after a lunch without alcohol
8. In a car, while stopped for a few minutes in traffic
0 points
(8 questions left)
No Problem
It is unlikely that you are abnormally sleepy.

Click the submit button below to share your Sinus Self-Assessment Quiz results with our office.

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