The following questions are designed to identify a sleep problem. Choose the most appropriate number for each situation. A score of 6 or more indicates the possibility of a sleep disorder and should be discussed with your physician or dentist.
Scale
In contrast to feeling tired, are you likely to dose or fall asleep in the following situation?
0=Never 1=Slight Chance 2=Moderate Chance 3= Regularly
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___Sitting & Reading?
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___Watching Television?
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___Sitting inactive in a public place (i.e. theater)?
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___Passenger in a car for an hour without a break?
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___Lying down to rest in the afternoon?
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___Sitting and talking to someone?
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___Sitting quietly after lunch without alcohol?
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___In a car while stopped for a few minutes in traffic? __________Total Score
Great article on TMJ and Sleep.
