Am I At Risk For Sleep Apnea?

Am I At Risk For Sleep Apnea?2017-09-26T08:29:09-05:00

Not all snorers have OSA but virtually everyone with OSA snores. In order to engage in a productive discussion with your doctor, complete the following questionnaire and discuss the results with him.

Please ask your bed partner to help you answer as accurately as possible. Answer all of the questions below.

1. Have you noticed or has your bed partner witnessed any episodes of gasping or choking during your sleep?

2. Has your bed partner witnessed you stop breathing?

3. Do you prefer to sleep sitting upright?

4. Do you wake frequently to use the bathroom?

5. Do you snore when you sleep on your side?

6. Do you snore in all sleep positions?

7. Have you had a recent increase in weight?

8. What is your height?

9. What is your weight?

10. What is your neck circumference?

Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

_______ft/in _______m

_______lb _________kg

Collar Size: _______in _______cm