Sleep Questionnaire

Quick and Simple Screening Test

MARITIME SLEEP CLINIC AND RESPIRATORY SERVICES - LA CLINIQUE DU SOMMEIL DES MARITIMES ET SERVICES RESPIRATOIRES

Do I need a sleep study?

Chances are, if you are visiting our website, you could be a candidate for a sleep study. More definitively, you can take a quick and simple screening test that will let you know if you should pursue testing or not. In order to determine whether you may be affected by some type of sleep disorder breathing, we kindly ask you to answer the following questionnaire.

Do you snore loudly (louder than normal talking or loud enough to be heard through closed doors)?

YesNo

Do you often feel tired, fatigued or sleepy during the day?

YesNo

Has anyone observed you stopping breathing during your sleep?

YesNo

Do you have or are you being treated for high blood pressure?

YesNo

Your Name (required)

Your Email (required)

Closest Location

You answered “YES” to less than 2 of the questions, you have to answer yes to at least 2 of the question to be considered at risk of experiencing some type of sleep disordered breathing.

Although you are not technically at risk, if you feel you are experiencing some symptoms related to sleep apnea, please feel free to reply to this email or contact us directly to receive more information.

You have answered “YES” to 2 or more of the questions, you may be at risk of experiencing some type of sleep disorder breathing.
Untreated, sleep apnea can lead to a variety of serious health conditions including high blood pressure, heart disease, stroke, type 2 diabetes and more.
A simple sleep study would tell us if sleep apnea is affecting you. To schedule a consultation you can simply reply to this email or contact us directly at the clinic closest to you. Our sleep study testing is free.

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