Dr. David Hershkowitz 224-24 Union Tpke #1m, Bayside, NY 11364 Phone (718) 468-3434

Sleep Health Questionnaire

Total Points:

Please add up the points from the questionnaire that were answered 'Yes" If the point total is greater than 2, the patient is a good candidate for a diagnostic sleep study.

0-2 = Lower risk of having Obstructive Sleep Apnea
3-4 = Moderate risk of having Obstructive Sleep Apnea
5-12 = High risk of having Obstructive Sleep Apnea

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