Take the Sleep Quiz | Assess Your Sleep Health

Sleep Quiz

First Name

Last Name

Phone/Mobile

Symptoms and Sleep Patterns

Identify the most common signs and symptoms of Sleep Apnea that occur during sleep.

Has anyone ever mentioned that you snore, especially if it’s loud or frequent?

Yes

Do you often remember having dreams when you wake up?

Yes

Do you wake up during the night experiencing chest pain or feeling short of breath?

Yes

Has anyone noticed or told you that you stop breathing or gasp for air while sleeping?

Yes

Do you ever wake up feeling like you are gasping for air or choking?

Yes

Do you often wake up with a dry mouth or throat?

Yes

How would you rate the quality of your sleep—restful, interrupted, or insufficient?

Restful

Interrupted

Insufficient

Daytime Impacts

Explore how poor sleep quality affects your energy, mood, and ability to focus during the day.

Do you frequently feel tired, fatigued, or excessively sleepy during the day?

Yes

Do you find it challenging to focus or complete tasks due to tiredness?

Yes

Do you frequently feel irritable or moody during the day?

Yes

Medical History

Review your health conditions to uncover risk factors related to Sleep Apnea.

Have you ever received a diagnosis of Sleep Apnea from a healthcare provider?

Yes

Have you been diagnosed with or experienced any of the following? (Select all that apply)

Diabetes

High Blood Pressure

Shortness of Breath

Stroke

Coronary Artery Disease

Congestive Heart Failure

Atrial Fibrillation

Lifestyle and Sleep Habits

Evaluate lifestyle factors and habits that may influence your sleep quality and overall health.

Do you consume caffeine or alcohol close to bedtime?

Yes

Do you have irregular sleep patterns or shift work that disrupts your sleep?

Yes

Do you wake up multiple times during the night for reasons other than using the restroom?

Yes

Sleep Environment

Assess whether your sleeping environment contributes to sleep disruptions.

Do you experience difficulty falling asleep or staying asleep in your current sleep environment?

Yes

Existing Treatment

Share details about any current treatments or observed behaviors during sleep.

Do you currently use a CPAP machine for sleep apnea treatment?

Yes

Have you been told you grind your teeth while sleeping?