REVITALIFE SLEEP ASSESSMENT

By clicking “I Agree” below you acknowledge that this is not a diagnostic instrument and is only to be used by you if you are 18 years or older. You agree that this application is for information purposes only and is not intended to replace a consultation with your doctor or a mental health professional. Revitalife Sleep Solutions disclaims any liability, loss, or risk incurred as a consequence, directly or indirectly, from the use and application of this test. If you are in need of immediate assistance, please dial 000 (Triple Zero).

If you have been experiencing sleep problems recently, the following questions ask you to describe your symptoms over the past 7 days. Tap “Continue” to start.

Step 1 OF 12
Progress
How likely are you to doze off in the following situations, rather than just feeling tired or fatigued?
Step 2 OF 12
Progress
Sitting and reading
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 3 OF 12
Progress
Watching TV
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 4 OF 12
Progress
Sitting inactive in a public place (eg a theatre or a meeting)
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 5 OF 12
Progress
As a passenger in a car for an hour without a break
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 6 OF 12
Progress
Lying down to rest in the afternoon when circumstances permit
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 7 OF 12
Progress
Sitting and talking to someone
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 8 OF 12
Progress
Sitting quietly after lunch without alcohol
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 9 OF 12
Progress
In a car, while stopped for a few minutes in the traffic
  • Would never doze
  • Slight chance of dozing
  • Moderate chance of dozing
  • High chance of dozing
Step 10 OF 12
Progress
Do you suffer from any of the following (can select more than one – tick box)?
Step 11 OF 12
Progress
What type of bed do you have?
  • Standard bed
  • Adjustable bed

YOURSleep Assessment

For more than 30 years we've been helping people get better sleep.
Together, let's figure out how to improve yours.
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