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Do you snore loudly (loud enough to be heard through closed doors)?
Yes
No
Do you often feel tired, fatigued, or sleepy during the daytime (such as falling asleep during driving or talking to someone)?
Yes
No
Has anyone observed you stop breathing or choking/gasping during your sleep?
Yes
No
Do you have or are you being treated for high blood pressure?
Yes
No
Age older than 50?
Yes
No
Is your shirt collar 16 inches (40 cm) or larger?
Yes
No
Are you male?
Yes
No
What is your weight (pounds)?
What is your height (inches)?
Body Mass Index

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