Sleep Apnea Risk Assessment

Answer the following questions to determine if you might be at risk for sleep apnea.

NIGHTTIME SYMPTOMS

(Check all that apply)

Snoring

Stopping breathing while sleeping

Waking up gasping or choking

Frequently waking up

Grinding your teeth

Waking up frequently to urinate

None of the above

DAYTIME SYMPTOMS

(Check all that apply)

Feeling sleepy or unintentionally dozing

Headaches in the morning

Difficulty with memory or concentration

Awake tired even after a full night’s sleep

Breathing through your mouth

None of the above

RISK FACTORS

(Check all that apply)

Overweight or obese

Coronary artery disease

High blood pressure

Congestive heart failure

Neck size > 17 (men)

Neck size > 15 (women)

Acid reflux or heartburn

Stroke

Type II Diabetes

Insomnia

Depression

Erectile Dysfunction

None of the above