The following questions relate to the behavior that you have observed in the patient, your bed partner, while he/she is asleep. Use the following scale to choose the most appropriate number for each situation.
Scoring
0 = Never
1 = Infrequently (1 night per week)
2 = Frequently (2-3 nights per week)
3 = Most of the time (4 or more nights per week)
- __ Loud, obtrusive or irritating snoring
- __ Choking or gasping for air
- __ Pauses in breathing
- __ Twitching / kicking of arms or legs
- __ Snoring requiring separate bedrooms
- __ Falling asleep inappropriately (ex. While driving or in meetings)
Total Score: __
Understanding Your Score
A score of 5 or greater indicates symptoms which are affecting the health, safety, or quality of life of the observed person.