- I feel tired during the day.
|
YES/NO
|
- I am obese or overweight.
|
YES/NO
|
- I wake up gasping for breath.
|
YES/NO
|
- My snoring keeps my partner awake.
|
YES/NO
|
- I have high blood pressure.
|
YES/NO
|
- Someone in my family has sleep apnoea.
|
YES/NO
|
- I use heavy machinery, work at heights, or drive a truck.
|
YES/NO
|
- I have diabetes.
|
YES/NO
|
- I have problems with erectile dysfunction.
|
YES/NO |
- I wake up with a headache.
|
YES/NO |
- I have been diagnosed with a mood disorder or mental illness.
|
YES/NO |
- I have fallen asleep whilst driving.
|
YES/NO |
- I have heart disease or have had a stroke.
|
YES/NO |
- I suffer from nasal allergy, sinusitis, and/or a blocked nose.
|
YES/NO |
- I have trouble concentrating during the day.
|
YES/NO |
- I am a smoker.
|
YES/NO |