Online Sleep TestTake our FREE online sleep test below Online Sleep Test " " indicates required fields Step 1 of 16 6% Part 1: How likely are you to doze off?Part 1 is consists of 8 quick questions. It follows the Epworth format, and asks how likely you are to doze off or fall asleep during the following situations. This is in contrast to just feeling tired.When sitting and reading? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing When watching television? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing When sitting inactive in a public place (e.g. a theatre/meeting) Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing As a passenger in a car for an hour with no break? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing When lying down in the afternoon? (when possible) Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing When sitting and talking to someone? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing When sitting quietly after lunch without alcohol? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing In a car, while stopped for a few minutes in traffic? Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing You have reached the end of Part 1, please continue to Part 2 to answer a few more questions. Part 2: OSA QuestionnairePart 2 consists of 8 questions. The following questions were pioneered by the University Health Network and follow the STOP-BANG format. This field is hidden when viewing the formOn average, how many hours of sleep do you get? Less than 3 Hours 3 - 6 Hours 6 - 8 Hours Over 8 Hours Do you often snore loudly? loud enough to be heard through closed doors Yes No Do you often feel Tired, Fatigued, or Sleepy during the daytime? e.g. falling asleep while driving or talking to someone Yes No Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep? Yes No Do you have or are being treated for High Blood Pressure? Yes No Is your neck size large? (Measured around Adams apple) For male, is your shirt collar 17 inches/ 43cm or larger?For female, is your shirt collar 16 inches / 41cm or larger? Yes No What is your gender? On average, Males are more likely to have sleep apnoea. Male Female Are you older than 50? Yes No BMI CalculationHeight (cm) Please Select Height...120 cm121 cm122 cm123 cm124 cm125 cm126 cm127 cm128 cm129 cm130 cm131 cm132 cm133 cm134 cm135 cm136 cm137 cm138 cm139 cm140 cm141 cm142 cm143 cm144 cm145 cm146 cm147 cm148 cm149 cm150 cm151 cm152 cm153 cm154 cm155 cm156 cm157 cm158 cm159 cm160 cm161 cm162 cm163 cm164 cm165 cm166 cm167 cm168 cm169 cm170 cm171 cm172 cm173 cm174 cm175 cm176 cm177 cm178 cm179 cm180 cm181 cm182 cm183 cm184 cm185 cm186 cm187 cm188 cm189 cm190 cm191 cm192 cm193 cm194 cm195 cm196 cm197 cm198 cm199 cm200 cm201 cm202 cm203 cm204 cm205 cm206 cm207 cm208 cm209 cm210 cm211 cm212 cm213 cm214 cm215 cm216 cm217 cm218 cm219 cm220 cmWeight (Kg) Please Select Weight...25 Kg26 Kg27 Kg28 Kg29 Kg30 Kg31 Kg32 Kg33 Kg34 Kg35 Kg36 Kg37 Kg38 Kg39 Kg40 Kg41 Kg42 Kg43 Kg44 Kg45 Kg46 Kg47 Kg48 Kg49 Kg50 Kg51 Kg52 Kg53 Kg54 Kg55 Kg56 Kg57 Kg58 Kg59 Kg60 Kg61 Kg62 Kg63 Kg64 Kg65 Kg66 Kg67 Kg68 Kg69 Kg70 Kg71 Kg72 Kg73 Kg74 Kg75 Kg76 Kg77 Kg78 Kg79 Kg80 Kg81 Kg82 Kg83 Kg84 Kg85 Kg86 Kg87 Kg88 Kg89 Kg90 Kg91 Kg92 Kg93 Kg94 Kg95 Kg96 Kg97 Kg98 Kg99 Kg100 Kg101 Kg102 Kg103 Kg104 Kg105 Kg106 Kg107 Kg108 Kg109 Kg110 Kg111 Kg112 Kg113 Kg114 Kg115 Kg116 Kg117 Kg118 Kg119 Kg120 Kg121 Kg122 Kg123 Kg124 Kg125 Kg126 Kg127 Kg128 Kg129 Kg130 Kg131 Kg132 Kg133 Kg134 Kg135 Kg136 Kg137 Kg138 Kg139 Kg140 Kg141 Kg142 Kg143 Kg144 Kg145 Kg146 Kg147 Kg148 Kg149 Kg150 Kg151 Kg152 Kg153 Kg154 Kg155 Kg156 Kg157 Kg158 Kg159 Kg160 Kg161 Kg162 Kg163 Kg164 Kg165 Kg166 Kg167 Kg168 Kg169 Kg170 Kg171 Kg172 Kg173 Kg174 Kg175 Kg176 Kg177 Kg178 Kg179 Kg180 Kg181 Kg182 Kg183 Kg184 Kg185 Kg186 Kg187 Kg188 Kg189 Kg190 Kg191 Kg192 Kg193 Kg194 Kg195 Kg196 Kg197 Kg198 Kg199 Kg200 KgBMI This field is hidden when viewing the formHeight divisionYou have reached the end of the screening test questions. Please fill in your details in Part 3 and we will process your results and email them within 5 minutes of submitting the screening test.Part 3: Patient DetailsThis field is hidden when viewing the formPost Title We have developed a unique algorithm exclusive to CPAP Online which combines the two different methods of sleep apnoea screening. We developed this algorithm to provide a more accurate result to find out if you are likely or unlikely to have sleep apnoea.First Name Last Name Email You will receive your results via email within 5 mins once our algorithm processes your test.Phone (optional)This field is hidden when viewing the formHave you ordered a home sleep study? Select an option...YesNoPlease select "Yes" here if you have purchased a Home Sleep Study from our store. We need a completed screening test to go along with the sleep study data to form a conclusive diagnosis. Otherwise choose "No" and ignore this option.This field is hidden when viewing the formWhat is your order number? Screening Test Reference CodeThis field is hidden when viewing the formEpworth ResultThis field is hidden when viewing the formEpworth Calculated ResultThis field is hidden when viewing the formEpworth Risk FactorThis field is hidden when viewing the formSTOP ResultThis field is hidden when viewing the formBANG ResultThis field is hidden when viewing the formSTOPBANG ResultThis field is hidden when viewing the formSTOPBANG Risk FactorThis field is hidden when viewing the formPharmacy Sleep Clinics Screening Test ResultThis field is hidden when viewing the formPost CategoryUncategorized
