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Sleep Questionnaire

The questionnaire below is a common tool for screening your risk-level for Obstructive Sleep Apnea. Answer the questions honestly and see your risk level immediately below.

The questionnaire below is a common tool for screening your risk-level for Obstructive Sleep Apnea. Answer the questions honestly and see your risk level immediately below.

Snoring: Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?

Tired: Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during during driving or talking to someone)?

Observed: Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

Pressure: Do you have or are being treated for High Blood Pressure?



Body Mass Index more than 35 kg/m2?

Age older than 50 years?

Neck size large? For males, is your shirt collar 17 inches or larger? For females, is shirt collar 16 inches or larger?

Gender = Male?

OSA Risk Level:

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