Excessive daytime sleepiness
<form><input type="radio" name="grp1" value="yes" id="y1"> <label for="y1">Yes</label> <input type="radio" name="grp1" value="no" id="n1"> <label for="n1">No</label></form>
Loud snoring
<form><input type="radio" name="grp1" value="yes" id="y2"> <label for="y2">Yes</label> <input type="radio" name="grp1" value="no" id="n2"> <label for="n2">No</label></form>
Observed episodes of breathing cessation during sleep
<form><input type="radio" name="grp1" value="yes" id="y3"> <label for="y3">Yes</label> <input type="radio" name="grp1" value="no" id="n3"> <label for="n3">No</label></form>
Abrupt awakenings accompanied by shortness of breath
<form><input type="radio" name="grp1" value="yes" id="y4"> <label for="y4">Yes</label> <input type="radio" name="grp1" value="no" id="n4"> <label for="n4">No</label></form>
Awakening with a dry mouth or sore throat
<form><input type="radio" name="grp1" value="yes" id="y5"> <label for="y5">Yes</label> <input type="radio" name="grp1" value="no" id="n5"> <label for="n5">No</label></form>
Awakening with chest pain
<form><input type="radio" name="grp1" value="yes" id="y6"> <label for="y6">Yes</label> <input type="radio" name="grp1" value="no" id="n6"> <label for="n6">No</label></form>
Morning headache
<form><input type="radio" name="grp1" value="yes" id="y7"> <label for="y7">Yes</label> <input type="radio" name="grp1" value="no" id="n7"> <label for="n7">No</label></form>
Difficulty concentrating during the day
<form><input type="radio" name="grp1" value="yes" id="y8"> <label for="y8">Yes</label> <input type="radio" name="grp1" value="no" id="n8"> <label for="n8">No</label></form>
Experiencing mood changes, such as depression or irritability
<form><input type="radio" name="grp1" value="yes" id="y9"> <label for="y9">Yes</label> <input type="radio" name="grp1" value="no" id="n9"> <label for="n9">No</label></form>
Difficulty staying asleep (insomnia)
<form><input type="radio" name="grp1" value="yes" id="y10"> <label for="y10">Yes</label> <input type="radio" name="grp1" value="no" id="n10"> <label for="n10">No</label></form>
Having high blood pressure
<form><input type="radio" name="grp1" value="yes" id="y11"> <label for="y11">Yes</label> <input type="radio" name="grp1" value="no" id="n11"> <label for="n11">No</label></form>
Ready?
If your answer is yes more than five times, you may be at risk of having sleep apnea and we would advise you to consider seeing your physician for a referral for a sleep test.