Sleep Disordered Breathing - Self Assessment Questionnaire | Sleep Clinic Services

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Sleep Disordered Breathing - Self Assessment Questionnaire

sleep-disordered-breathing-self-assessmentComplete our online Sleep Assessment Questionnaire to quickly and easily estimate your likelihood of having a serious Sleep Disordered Breathing (SDB) condition.

Our unique questionnaire combines a range of scientifically validated and professionally approved screening systems to quickly provide you with the most accurate estimate of your potential SDB condition. 

Your results will provide a very good indication of whether you have a significant SDB condition – but the results are not conclusive. The only truly accurate and professionally recognised method of diagnosis is via a diagnostic sleep study.

A diagnostic sleep study or polysomnogram (PSG) is the ‘gold standard’ for the professional diagnosis of SDB. A professional sleep study will monitor your breathing, cardiac activity, brain activity, limb movement, sleeping position, blood oxygen levels and much more; while you sleep.

If you'd like to ask some questions or have a chat with one of our Care Coordinators, you have three options.

Call during business hours on 1300 246 637.

Or Submit the form below.

Or Click on the button and choose a time for a call-back.  

Either way, a Care Coordinator will call to answer your questions and give you whatever information you're looking for, no cost or obligation. If you wish, they can also do a free Sleep Disorder Screening for you. This free check will assess your sleep health and your eligibility for Medicare coverage.

Get in touch now! Call or use the form for an ASAP reply, or click the button to book a call-back time.

Book a Call-Back

Section 1. What is your Body Mass Index (BMI)?
(e.g. 92)
(eg. 180)

If your BMI total does not display automatically after entering both your weight and height details, check that these values have been entered correctly and please try again (kilograms and centimetres).

Section 2. What is your 'Adjusted Neck Circumference'?
Start with your normally measured neck circumference (i.e., your collar size). Then add the relevant amounts to arrive at your ‘ANC’
(cm)
Enter 3 for YES or 0 for NO.
Enter 3 for YES or 0 for NO.
Enter 4 for YES or 0 for NO.
Section 3. What are your general sleep/waking patterns?
Section 4. Epworth Sleepiness Scale
In the section below, enter the number that best describes your likelihood of dozing in the corresponding situations. 0=Never    1=Sometimes    2=Likely    3=Highly Likely
Section 5. Karolinska Scale
In this section, describe your level of alertness ‘right now’ as you complete this form
Preliminary Assessment
Note: This assessment is not a substitute for a full diagnostic sleep study.
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Submit your results for an obligation-free chat with a professional Sleep Therapist now.
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