Sleep Apnea Risk Survey

THE FOLLOWING QUESTIONS ARE ABOUT YOUR HEALTH, DAYTIME TIREDNESS AND SNORING HABITS.

Your answers to the quick survey below can help identify your risk of Obstructive Sleep Apnea (OSA). After you answer the questions, click "submit and continue" to see your results.

OSA can negatively affect the quality of life of people of all ages. At its most severe, a lack of sleep caused by OSA can lead to high blood pressure, abnormal heart rhythms, heart attack or strokes.

Health

Do you have high blood pressure?

Epworth Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations in contrast to just feeling tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the scale below to choose the most appropriate frequency for each situation.

Sitting and reading

Watching television

Sitting, inactive, in a public place (e.g., theater, meeting)

Sitting as a passenger in a car for an hour without a break

Lying down to rest in the afternoon when circumstances permit

Sitting and talking to someone

Sitting quietly after a lunch without alcohol

Sitting in a car while stopped for a few minutes in traffic

Snoring

Do you snore often (three or more nights per week)?

Have you been told that during sleep, you frequently stop breathing or gasp for air?

General Information

Height

feet

inches

Weight (lb)

Neck Size

Ethnicity Age

Gender