Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?

• yes

• no

Do you often feel tired, fatigued, or sleepy during the daytime?

• yes

• no

Has anyone observed you stop breathing during your sleep?

• yes

• no

Do you have or are you being treated for high blood pressure?

• yes

• no

Is your BMI ≥ 35 kg/m2?

• yes

• no

Are you > 50 yrs old?

• yes

• no

Male or female?

• Male

• Female

Is your neck circumference >40cm?

• yes

• no