Sleep Observer Scale

The following questions relate to the behavior that you have observed in the patient is while he/she is asleep. Use the following scale to choose the most appropriate number for each situation.

0=Never
1=Infrequently (1 night per week)
2=Frequently (2-3 nights per week)
3=Most of the time (4 or more nights per week)

•  Loud, irritating snoring ______

•  Choking or gasping for air _______

•  Pauses in breathing _______

•  Twitching / kicking of arms or legs _______

•  Snoring requiring separate bedrooms _______

•  Falling asleep inappropriately (example: while driving or at meetings)_______

Total score ______

A score of 5 or greater indicates symptoms which are affecting the health, safety, or quality of life of the observed person.