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 sleep?
*
Yes
No
Do you have (or are you being treated for) high blood pressure?
*
Yes
No
Sex
*
Male
Female
Age
*
AGE-SCORE
*
Weight [lbs]
*
Height [feet]
*
Height [inches]
*
BMI
BMI-SCORE
*
BMI-SCORE
*
Neck circumference [inches]
*
NECK-SCORE
*
STOP-BANG-SCORE
*
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