Sleep Questionnaire

Answer the following questions to determine your risk for Sleep Apnea:

Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?YesNo
Do you often feel TIRED, fatigued, or sleepy during daytime?YesNo
Has anyone OBSERVED you stop breathing during your sleep?YesNo
Do you have or are you being treated for high blood PRESSURE?YesNo
BMI more than 35kg/m2?YesNo
AGE over 50 years old?YesNo
NECK circumference > 16 inches (40cm)?YesNo
GENDER: Male?YesNo


  • High risk of OSA: Yes 5 - 8
  • Intermediate risk of OSA: Yes 3 - 4
  • Low risk of OSA: Yes 0 - 2