Risk of Sleep Apnea Questionnaire
We want to help you sleep better.
To get started, answer these questions to see if you are at a higher risk of sleep apnea.

*1. Have you ever been told that you snore loudly (louder than talking or loud enough to be heard through closed doors)?
*5. Is your BMI more than 35?
*2. Do you often feel tired, fatigued or sleepy during the day?
*6. Is your neck size circumference 16 inches or greater?
*3. Has anyone told you that you stop breathing during your sleep?
*7. Are you over 50 years old?
*4. Do you have or are you being treated for high blood pressure?
*8. Are you a male?
If you answered ‘yes’ to three or more questions, your risk of sleep apnea may be high.
Would like to have someone from Fairview Sleep Centers contact you?
Thank you for your interest in Fairview Sleep Centers. If you have any questions, please contact us at 612-273-5000.
*First Name
*Last Name
*Zip Code
Email address
*Phone Number

Security Notice: This form sends information via secure socket layers encryption. The information transmitted from this form is secure and confidential.