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Obstructive Sleep Apnea Questionnaire

Obstructive Sleep Apnea Questionnaire

Call Us: 866-431-7431
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STOP-BANG Questionnaire

Answer these eight simple questions to determine if your symptoms may be attributed to obstructive sleep apnea.

 

STOP

  1. Do you SNORE loudly? (Loudly is usually defined as loud enough to be heard through a closed door or loud enough to disturb a bed partner).

YES 

NO

 

  1. Do you often feel TIRED, fatigued, or sleepy during the day?

YES 

NO

 

  1. Has anyone OBSERVED you stop breathing while sleeping?

YES 

NO

 

  1. Do you have or are you being treated for high blood PRESSURE?

YES 

NO

BANG

  1. Is your BMI more than a 35? (You can calculate your BMI: 703 x (Weight in lbs) / (height in inches)2 ) or use this BMI calculator.

YES

NO

 

  1. AGE over 50-years-old?

YES

NO

 

  1. Is your NECK circumference greater than 16 inches (40 cm)?

YES

NO

 

  1. GENDER male?

YES

NO

Calculate your risk of obstructive sleep apnea

NUMBER OF “YES” RESPONSES RISK OF OBSTRUCTIVE SLEEP APNEA
5-8 High Risk
3-4 Intermediate Risk
0-2 Low Risk

If you are in the intermediate-risk or high-risk category and you’re experiencing excessive daytime sleepiness or have other sleep concerns, it may be time to see your provider.

 

Request an appointment today