Solea Snoring Treatment Screening Form

Do you snore loud enough to be heard through closed doors and/or does your partner elbow you?

Do you often feel tired during the day?

Do you fall asleep driving or talking to some one?

Has anyone observed you stopped breathing, choking or gasping during sleep?

Do you have high blood pressure?

Is your BMI more than 35kg/m2?

Is your age older than 50?

Is your neck size large, shirt collar > 16 inches (40cm)?

Is your gender male?