Apnea Test

Sleep Test Home
Sleep Disorder Screening Questionnaire
A general questionnaire to fill out and return to your physician.
Apnea Sleep Test
Sleep test to evaluate the possiblity of having sleep apnea.
Insomnia Sleep Test
Sleep test to evaluate the possiblity of having insomnia.

Sleep Apnea Test

Complete the test below. If you answer “yes” to two or more questions, you may have sleep apnea. Contact the East Alabama Sleep Disorders Center at 334-528-2404 for a consultation.

I've been told that I snore

YesNo

I've been told that I stop breathing while I sleep, although I don't remember this when I wake up

YesNo

I have high blood pressure

YesNo

I sweat excessively during the night

YesNo

I get morning headaches

YesNo

I suddenly wake up gasping for breath during the night

YesNo

I am overweight

YesNo

I experience aching or "crawling" sensations in my legs

YesNo

Sometimes I can't keep my legs still at night

YesNo

Sleep Apnea Total

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