• (972) 838-1892
  • PATIENT FORMS
  • 1701 Eldorado Pkwy Suite 250, Mckinney, TX 75069
  • Mon - Fri : 9:00 AM - 5:00 PM
  • Shahrukh A Kureishy M.d., F.C.C.P. Board Certified Pulmonologist
  • (972) 838-1892
  • PATIENT FORMS
  • 4833 Medical Center Drive, Suite 6B, McKinney, TX 75069
  • Mon - Fri : 9:00 AM - 5:00 PM
  • Shahrukh A Kureishy M.d., F.C.C.P. Board Certified Pulmonologist
  • (972) 838-1892
  • PATIENT FORMS
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  • How Sleepy Are You?
  • Are you likely to doze off or fall asleep in the following situations?
  • 0 = would never doze
  • 1 = slight chance of dozing
  • 2 = moderate chance of dozing
  • 3 = high chance of dozing
  • 1. Sitting and reading :
  • 2. Watching T.V.:
  • 3. Sitting in a public place (theater, church, meeting, etc) :
  • 4. A passenger in a car for at least an hour :
  • 5. Resting in the afternoon :
  • 6. Sitting and talking to someone :
  • 7. Sitting quietly after lunch :
  • 8. In a car, stopped, for a few minutes in traffic :
  • Score Total :
  • Results
  • 0-10 - could indicate a low chance of apnea.
  • 11-20 - could indicate a mild chance of sleep apnea.
  • Above 20 - could indicate a high chance of apnea.

1701 Eldorado Pkwy Suite 250,
Mckinney, TX 75069

Call us : (972) 838-1892
Fax: 214-548-4205

Mon – Fri: 9:00AM – 5:00PM
Sat – Sun: Closed
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