Sleep Assessment

Epworth Sleepiness Scale

Complete the following survey for an evaluation of the likelihood you have issues with sleep apnea. Even if you haven't done some of these things recently, try to work out how they would have affected you.

It's important that you answer each question as best you can.

How likely are you to doze off or fall asleep in the following situation, in comparison to feeling just tired? This refers to your usual way of life in recent times.

Sitting and reading
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

Watching TV
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

Sitting still in a public place (for example, a theater, the cinema, a meeting)
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

As a passenger in a car for an hour without a break
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

Lying down to rest in the afternoon when the circumstances allow
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

Sitting and talking to someone
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

Sitting quietly after lunch without having drunk alcohol
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

In a car or bus while stopped for a few minutes in traffic
0 (would not doze)
1 (slight chance of dozing)
2 (moderate chance of dozing)
3 (high chance of falling asleep)

Enter your answer(Required)

Please enter a number from 0 to 3.

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Your Score

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May we contact you via phone or email to discuss your results and ask if you’d like to schedule a free consultation?(Required)

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Questions about our

Sleep Apnea Treatments

How can I be sure my oral appliance will be comfortable?

CinciSleep will take digital scans of your mouth at your consultation appointment. This allows us to create precise 3D models of your mouth and ensure the best possible oral appliance fit.

If I am a loud snorer, does that automatically mean I have sleep apnea?

No, it does not. Not all loud snorers have sleep apnea, and not all people with sleep apnea are loud snorers. If snoring is disrupting your (or your partner’s) sleep, we recommend making an appointment with us so we can investigate your condition further.

Are you ready to improve your sleep?

At CinciSleep our mission is to help you get the best night’s sleep possible. Treat your snoring and sleep apnea with a simple and comfortable solution!

Great dentist that got my sleep apnea under control with a mouth appliance. State-of-the-art practice. Dentist and staff very professional. Beautiful office with state or art equipment.

DOUG H.