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Questionnaire

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Step 1 of 3

33%

Are you often tired?*
- Yes
- No
Do you snore?*
- Yes
- No
Have you ever woken up gasping for breath?*
- Yes
- No
Has anyone ever witnessed you stop breathing when asleep?*
- Yes
- No
Do you wake frequently throughout the night?*
- Yes
- No
Do you visit the bathroom more than once at night?*
- Yes
- No
Do you suffer from morning headaches?*
- Yes
- No
Do you wake up feeling unrefreshed?*
- Yes
- No
Have you ever fallen asleep at an inappropriate time?*
- Yes
- No
Do you suffer from poor memory or concentration?*
- Yes
- No

Do you have reduced libido?*
- Yes
- No
Have you ever had a accident or ‘near miss’ because of tiredness?*
- Yes
- No
Are moody or depressed?*
- Yes
- No
Do you have Diabetes?*
- Yes
- No
Do you have high blood pressure?*
- Yes
- No
Do you have atrial fibrillation or other heart disease?*
- Yes
- No
Are you a current smoker?*
- Yes
- No
Are you overweight?*
- Yes
- No
Are you Male?*
- Yes
- No
Are you over 50 years old?*
- Yes
- No

Thank You for completing the Quiz

Your score is:

{quiz_score}

Out of 20

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Call 07 3287 2385

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