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SLEEP APNEA CHANCES

Select your chance of dozing while doing each of the following activities:

Sitting and Reading

Watching Television

Sitting inactive in a public place (e.g., a theater or a meeting)

As a passenger in a car for an hour without a break

SLEEP APNEA CHANCES CONTINUED

Select your chance of dozing while doing each of the following activities:

Lying down to rest in the afternoon when circumstances permit

Sitting and talking to someone

In a car, while stopped for a few minutes in traffic

Sitting quietly after a lunch without alcohol

YES / NO QUESTIONS

Answer these yes / no questions:

Yes NoDo you snore loudly?
(louder than talking or loud enough to be heard through closed doors)
Yes NoDo you often feel tired, fatigued, or sleepy during daytime?
Yes NoHas anyone observed you stop breathing during your sleep?
Yes NoDo you have or are you being treated for high blood pressure?
YES / NO QUESTIONS CONTINUED

Answer these yes / no questions:

Yes NoIs your Body Mass Index greater than 28?
Yes NoAre you over 50 years old?
Yes NoAre you a man with a neck circumference greater than 17 inches?
Or a woman with a neck circumference greater 16 inches?
YOUR SLEEP APNEA SCORE

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1690 Rimrock Road Suite C
Billings, MT 56102

406-206-3333

OFFICE HOURS

Monday - Wednesday:

8:00 am - 5:00 pm

Thursday:

7:00 am - 4:00 pm

Friday:

By Appointment

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