Assess Your Risk of Sleep Apnea
* Required
Email address
*
Your email
Full name as per IC
*
Your answer
Age
*
Your answer
Mobile Number (012-3456788)
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Your answer
Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
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Yes
No
Do you often feel TIRED, fatigued, or sleepy during daytime?
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Yes
No
Has anyone OBSERVED you stop breathing during your sleep?
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Yes
No
Do you have or are you being treated for high blood PRESSURE?
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Yes
No
BMI > 28kg/m2?
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Yes
No
Age > 50 years old?
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Yes
No
Neck circumference > 38cm?
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Yes
No
Male GENDER?
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Yes
No
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake the responsibility to inform you of any changes therein, immediately.
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