* 1. Do you snore while sleeping?

* 2. Do you gasp/choke while sleeping?

* 3. Is your neck size greater then 17inch (male), 16inch (female)?

* 4. Do you feel tired during the day?

* 5. Do you have high blood pressure?

* 6. Do you have morning headaches?

* 7. Do you do shift work?

If you have answered yes to any of these questions, please enter your contact information below if you are interested in getting tested for sleep apnea and want to discuss the results of your survey.

* 8. Your Contact Information