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Sleep Surgery Clinical Trial Website screening

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Sleep Surgery Clinical trial for Obstructive Sleep Apnoea

Please make a selection for EACH QUESTION

  No Yes  
1. Have you been previously diagnosed by a doctor with obstructive sleep apnoea (OSA)?
2. Have you tried continuous positive airway pressure (CPAP)?
3. Do you currently use CPAP all night, every night to treat your OSA?
4. Are you aged 18 to 70 years (inclusive)?
5. Please indicate a location where you would prefer to attend: Daw Park SA; Adelaide city; Sydney; Wollongong or Perth? Daw Park Adelaide CBD
Sydney Wollongong
Perth

Epworth Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently try to work out how they would have affected you.
Please tick one response (the most appropriate for you) for each question below.

SITUATION Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing
Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in the traffic


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