Sleep

Yes No

Do you snore loudly?

Yes No

Do you often feel tired, fatigued, or sleepy during the daytime?

Yes No

Has anyone seen you stop breathing while you were sleep?

Yes No

Do you have or are you being treated for high blood pressure?

Yes No

Do you have high cholesterol or take medication to treat high cholesterol?

Yes No

Are you obese or very overweight (BMI more than 35 kg/m²)?

Yes No

Are you over 50 years old?

Yes No

Do you smoke, use tobacco products, or are you exposed to second-hand smoke on a daily basis?

Yes No

Is your neck circumference more than 16 inches?

Yes No

Are you male?

Sleep Apnea Assessment