Sleep Apnea Questionnaire

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

Yes

No

Looks good!

Please provide an answer

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

Yes

No

Looks good!

Please provide an answer

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

Yes

No

Looks good!

Please provide an answer

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

Yes

No

Looks good!

Please provide an answer

Body Mass Index more than 35 kg/m2 ?
Use any online calculator to determine your body mass index.

Yes

No

Looks good!

Please provide an answer

Age older than 50?

Yes

No

Looks good!

Please provide an answer

Neck size large ? (Measured around Adams apple)
For male: is your shirt collar larger than 17 inches / 43cm?
For female: is your shirt collar larger than 16 inches / 41cm?

Yes

No

Looks good!

Please provide an answer

Gender ?

Male

Female

Looks good!

Please provide an answer

Sleep Apnea Questionnaire Sherwood Park

Undiagnosed Sleep Apnea is a major risk and can even be life-threatening.

If you are not sure you have sleep apnea, take this quick 2 minute questionnaire to determine the risks of having Obstructive Sleep Apnea (OSA). We will contact you back with results.

STOP-BANG Questionnaire