Harvard Sleep Apnea Questionnaire

Do you snore on most nights (4 or more nights a week)?*

Is your snoring loud enough to be heard through a wall?*

Have you been told that you stop breathing or gasp during sleep?*

What is your collar size?*

Do you occasionally fall asleep when driving or stopped at a light?*

Do you occasionally fall asleep when you are busy or active?*

Have you been diagnosed with or are you being treated for high blood pressure?*

Your Score

Your score will display here when all the questions above are answered.

If your score was 9 or higher, you should refer to a sleep dentist. Scores between 6-8 are still considered to be at risk. Scores of 5 or below have a low probability of sleep apnea. A score below 9 does not necessarily mean that you do not have a problem. If you suspect that you may have sleep apnea, you should see a sleep dentist.

CONTACT DR. STAFFORD RIGHT AWAY TO DISCUSS YOUR PROBLEMS WITH DAYTIME SLEEPINESS.

Have Dr. Stafford follow up with me about my results

Have Dr. Stafford follow up with me about my results

Email the results to me*

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This field is for validation purposes and should be left unchanged.