Are you at risk for OSA?

Determine your risk for OSA

Please answer the following questions below to determine if you might be at risk.

YesNo

Do you snore loudly or have you been told you snore loudly?

YesNo

Do you experience daytime sleepiness or drowsiness? Do you suffer from fatigued driving?

YesNo

Have you ever stopped breathing while sleeping or been observed choking/gasping for air while sleeping?

YesNo

Do you have high blood pressure?

Body Mass Index Calculator

Please populate both the height and weight fields in order to calculate BMI

Height (in)

Weight (lb)

Calculate BMI

YesNo

Is your BMI higher than 35?

YesNo

Are you over the age of 50?

YesNo

Do you have a large collar size? (Measured around Adams apple) For male, is your shirt collar 17 inches / 43cm or larger? For female, is your shirt collar 16 inches / 41cm or larger?

YesNo

Are you male?

Zip Code (required)

By clicking below you acknowledge that you are sharing anonymous screening information, including your zip code with DreamSleep.

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Please fill out the form below if you wish to be matched with a DreamSleep Certified Provider in your area.

School or Organization (required)

First and Last Name (required)

Phone Number (required)

Email (required)

Allergies (required)

Currently have braces or orthodontics? (required)

Zip Code (required)

Symptoms:

SnoringWaking during the nightGasping for airDaytime sleepinessFrequent napsDry Mouth or Sore ThroatHeadaches in the MorningDifficulty ConcentratingForgetfulnessDepressionFeeling IrritableNight SweatsRestless SleepOther

By clicking "Continue" below I acknowledge that I am sharing my contact information, zip code, symptoms and screening assessment with DreamSleep and that a DreamSleep Certified Provider may contact me to schedule a follow up appointment.(required)

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Are you at risk for OSA?

Determine your risk for OSA

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