Berlin Sleep Apnoea Questionnaire
 
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Home Sleep Study | Berlin Questionnaire

Berlin Questionnaire Sleep Test Questionnaire
Category (1) Please answer all questions
Do you snore

Yes
No
Don't Know		 Your snoring is

Slightly louder than breathing
As loud as talking
Louder than talking
Very loud – can be heard in adjacent rooms
How often do you snore

Nearly every day
3-4 times a week
1-2 times a week
1-2 times a month
Never or nearly never
Has your snoring ever bothered other people

Yes
No
Don't Know
Has anyone noticed that you quit breathing during your sleep

Nearly every day
3-4 times a week
1-2 times a week
1-2 times a month
Never or nearly never 		 
 Category 1 Score is 
Category (2) Please answer all questions
How often do you feel tired or fatigued after your sleep

Nearly every day
3-4 times a week
1-2 times a week
1-2 times a month
Never or nearly never
During your waking time, do you feel tired, fatigued or not up to par

Nearly every day
3-4 times a week
1-2 times a week
1-2 times a month
Never or nearly never
Have you ever nodded off or fallen asleep while driving a vehicle -->

Yes
No 		If Yes, how often does this occur

Nearly every day
3-4 times a week
1-2 times a week
1-2 times a month
Never or nearly never
 Category 2 Score is 
Category (3) Please answer all questions
Do you have high blood pressure

Yes
No
Don't Know 		Is your BMI greater than 30 (Calculate below)

Yes
No
 Category 3 Score is 
BMI Calculator   Berlin Questionnaire Results
Weight (in Kilos)  
Height (in Centimeters)  
BMI =
  High Risk of Sleep Apnea Syndrome:
If there are 2 or more Categories where the score is 2 or above

Low Risk of Sleep Apnea Syndrome:
If there is only 1 or no Categories where the score is 2 or above

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