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Is Snoring  a   problem?  

 

  • Have you ever been diagnosed or treated for sleep apnea
  • Do you have allergies or problems breathing? 
  • Do you have any problems with breathing through your nose?
  • Do you drink alcohol and or take sedatives six hours prior to going to sleep? 
    • Are their disorders of sleep apnea in your family? 
    • Have you sought treatment for snoring? 
    • Do you tend to be tired in the afternoon?
    • Do you sleep but not wake up refreshed?

    Feel free to print this and fill it out before coming in to our office. Might also be a good idea to give a copy to that spouse who snores!

     

    Patient Name:                                                                     Date of Birth:                            

     

    EPWORTH SLEEPINESS SCALE

     

    In contrast to just feeling tired, how likely are you to doze off or fall asleep in the following situations? 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 or each situation.

                                              0 = WOULD NEVER DOZE

                                              1 = SLIGHT CHANCE OF DOZING

                                              2 = MODERATE CHANCE OF DOZING

                                              3 = HIGH CHANCE OF DOZING

     

    SITUATION                                                                   CHANCE OF DOZING

    Sitting and Reading                                                                                              

    Watching TV                                                                                                          

    Sitting inactive in a public place (i.e., in a theatre)                                            

    As a car passenger for an hour without a break                                                

    Lying down to rest in the afternoon                                                                     

    Sitting and talking to someone                                                                             

    Sitting quietly after lunch (without alcohol)                                                          

    In a car, while stopping for a few minutes in traffic                                             

     

                                                              TOTAL SCORE =                                       

    Have you had a sleep study? ________

    Do you own a CPAP? ______ If so, do you use it nightly?_________

     

    SIGNATURE: ____________________________     DATE: _________          

    Take a More Detailed Sleep Test Here and Find Out Your Score ONLINE

    Treatment for Snoring is:

    1. Do nothing. 

    2. Sleep on your side rather than your back.

    3. Exercise and weight loss reduction.

    4. Use Continuous Positive Airway Pressure (CPAP).

    5. Use the SnoreGuard, TheraSnore, The Silent Night, the O2 Oasys, or, the Silencer. Click here to find out about the Silencer or the Oasys System.

                  
          Silent Night Appliance    Oasys Appliance

    Email us if you answered "yes" to any of these questions. 

    Please e-mail Dr. Williams with any suggestions or
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