Good Sleep Means Good Business

Employer Sleep Apnea Questionnaire

Please answer Yes or No to the following five questions.

1) Do your top three medical expenditures include any of these?
  Yes  No

  • High blood pressure
  • Heart disease
  • Diabetes
  • Obesity
  • Depression
  • Stroke

2) Are a large percentage of your employees of male gender?
  Yes  No

3) Do you employ any of the following high risk occupations?
  Yes  No

  • Assembly Line
  • Commercial Drivers
  • Construction
  • Firefighters
  • Military
  • Pilots
  • Police Officers
  • Shift Workers
  • Utility
4) Has the topic of sleep/fatigue been addressed in your industry?
  Yes  No
5) Are you concerned your employee(s) may have sleep apnea?
  Yes  No
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