2. Do you snore every night?
Yes
No

3. Have you ever been told that you hold your breath during sleep (stop breathing for at least ten seconds?)
Yes
No

4. Have you woken short of breath during sleep?
Yes
No

5. Are you restless during sleep?
Yes
No

6. Do you wake tired?
Yes
No

7. Are you drowsy in the afternoon?
Yes
No

8. Do you fall asleep easily during the day?
Yes
No

9. Do you feel tired after lunchtime?
Yes
No

10. Have you fallen asleep during driving?
Yes
No

11. Have you arrived home without memory of the trip?
Yes
No

12. Has your partner or spouse moved to another bedroom?
Yes
No

13. Are you depressed?
Yes
No

14. Are you irritable on waking in the morning?
Yes
No

15. Do you have high blood pressure?
Yes
No

16. Do you have trouble breathing through the nose?
Yes
No

17. Do you suffer from allergy or hayfever?
Yes
No

18. Do you suffer (or have you suffered) from indigestion, heartburn or gastric ulcers?
Yes
No

19. Do you smoke?
Yes
No

20. Do you perform regular physical exercise?
Yes
No