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:

None
Slight
Mild
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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