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Sleep Apnea Test
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* Indicates required question
Do you snore while sleeping?
*
Yes
No
Unsure
Do you gasp/choke while sleeping?
*
Yes
No
Unsure
Do you feel tired during the day?
*
Yes
No
Unsure
Do you have high blood pressure?
*
Yes
No
Unsure
Do you have morning headaches?
*
Yes
No
Unsure
Do you do shift work?
*
Yes
No
Unsure
Have you had a sleep test done?
*
Yes
No
Unsure
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