Sleepiness Self Test

The only way to be sure if you have obstructive sleep apnea is to have a sleep test from a qualified sleep technician. A score of 9 or above on this test is an indication that you should see your doctor.

Please feel free to print this test, fill it out and bring it with you for a complimentary consultation with Dr. Provencher, who will then discuss your options.


How likely are you to doze off or fall asleep in the following situations? Choose the most appropriate number for each situation:

  • 0 – would never doze
  • 1 – slight chance of dozing
  • 2 – moderate chance of dozing
  • 3 – high chance of dozing


  • Sitting and reading _____
  • Watching TV _____
  • Sitting, inactive in a public place (theatre, meeting) _____
  • As a passenger in a car for an hour without a break _____
  • Lying down to rest in the afternoon when possible _____
  • Sitting and talking to someone _____
  • Sitting quietly after lunch without alcohol _____
  • In a car, while stopped for a few minutes in traffic _____
  • TOTAL __________

A score of 9 or above indicates you may be having a problem with daytime sleepiness but below 9 does not necessarily mean that you don’t have a problem. Book for a complimentary consultation for professional advice if you snore, have been told that you wake gasping for breath or if you are sleepy during the day.