Sleep Apnea Evaluation

The Sleep Apnea Evaluation Quiz is an important tool designed to both quickly and easily determine if a sleep disorder could possibly be present or be a factor in your overall health and well being.

A person who stops breathing for 10 seconds up to 30 times per night is considered to be a sleep apnea sufferer. Sleep apnea is an extremely serious condition that causes a person to wake up constantly throughout the night from respiratory disturbances. Snoring may be indicative of sleep apnea, which can put a great strain on the cardiovascular system. Hypertension (high blood pressure, eventually renal failure), diabetes, heart failure and stroke are very common in people who suffer from sleep apnea. This condition is serious and should not be left untreated.

By taking the following quiz, we trust that the findings will serve as a useful guide for your future medical treatments. Please note that the results provided are not substitute for medical assessment by a doctor or any other diagnostic procedures.

Begin the evaluation by answering the first question below:

What is your sex? MaleFemale How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation: 0 = would never dose 1 = slight chance of dozing 2 = moderate chance of dozing 3 = high chance of dozing Situation Chance of dozing Sitting and reading 0123 Watching TV 0123 Sitting, inactive in a public place (theatre, meeting) 0123 As a passenger in a car for an hour without a break 0123 Lying down to rest in the afternoon when time permits 0123 Sitting and talking to someone 0123 Sitting quietly after a lunch w/out alcohol 0123 In a car, while stopped for a few minutes 0123

Your score indicates you may not have OSA. If you feel you have symptoms, consult with Dr. Jelinek or your personal care physician.

Your answers to these questions indicate that you may be at risk for Obstructive Sleep Apnea. You should consult with your physician and Dr. Jelinek to see what treatment options are available to you. Dr. Jelinek is qualified to evaluate and screen you for OSA. He can refer you to the appropriate physician and work with a medical team to explore the best treatment option for you. Call 888-913-6750 if you would like to arrange a personal consultation with Dr. Jelinek.

What is your bed partner's sex? MaleFemale The following questions relate to the behavior that you have observed in your bed partner while he/she is asleep. Use the following scale to choose the most appropriate number for each situation: 0 = Never 1 = Infrequently (1 night per week) 2 = Frequently (2-3 nights per week) 3 = Most of the time (4 or more nights perweek) Symptom Frequency Rating Loud, obtrusive or irritating snoring 0123 Choking or gasping for air 0123 Pauses in breathing 0123 Twitching/kicking of arms or legs 0123 Snoring requiring separate bedroom 0123 Falling asleep inappropriately (example: while driving or in meetings) 0123

With a score of less than 5 your partner may not suffer from OSA. If you feel they have some symptoms, consult Dr. Jelinek or your personal care physician.

A score of 5 or greater indicates symptoms which are affecting the health, safety, or quality of life of the observed person. Dr. Jelinek is qualified to evaluate and screen them for OSA. He can refer you to the appropriate physician and work with a medical team to explore the best treatment option. Call 888-913-6750 if you would like to arrange a personal consultation with Dr. Jelinek.