Patient Information Age (required) Screening Questions 1. Snoring – Do you snore loudly? YesNo 2. Tired – Do you often feel tired or sleepy during the day? YesNo 3. Observed – Has anyone observed you stop breathing or gasp at night? YesNo 4. Pressure – Do you have or are you being treated for high blood pressure? YesNo 5. BMI – Is your Body Mass Index > 35 kg/m²? YesNo 6. Neck size – Is your neck circumference ≥ 16 inches / 40 cm? YesNo Calculate Score Print Result Δ
