Sleep Apnea Assesment For Adults - Sara Amini London Dental Care

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

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

Has anyone observed you stop breathing during your sleep? *YesNo

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

Is your BMI more than 30 kg/m²? *YesNo

Are you over 50 years old? *YesNo

Is your neck circumference greater than 17 inches / 43 cm (men), 16 inches / 41 (women)? *YesNo

Are you male? *YesNo

Name *

Phone *

Email Address *

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