At Drake Family Dentistry we not only care about your oral health and smile, but we also are interested in your overall health. Therefore, we would appreciate it if you would thoughtfully fill out this survey with a yes or no after each question. Then send it back to us so we can set up a consultation to help you on your journey to a more enjoyable and better quality of life.

Sleep Apnea Survey

OSA – Low Risk : Yes to 0 – 2 questions
OSA – Intermediate Risk : Yes to 3 – 4 questions
OSA – High Risk : Yes to 5 – 8 questions
or Yes to 2 or more of 4 STOP questions + male gender
or Yes to 2 or more of 4 STOP questions + BMI > 35kg/m2
or Yes to 2 or more of 4 STOP questions + neck circumference 17 inches / 43cm in male or 16 inches / 41cm in female

Predisposing Conditions to Obstructive Sleep Apnea

Condition
Obesity
Age
Gender
Neck Circumference

Example
Adult Obesity
More that 50 years
Male
More than 40cm