| Please
answer all quesions |
YES |
NO |
Snoring: Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?
|
|
|
| Tired: Do you often feel tired, fatigued or sleepy during daytime? |
|
|
| Observed: Has anyone observe you stopping breathing during your sleep? |
|
|
| Blood pressure: Do you have or are you being treated for high blood pressure? |
|
|
| BMI: Is your BMI more than 35kg/m2? |
|
|
| Age: Are you over 50 years old? |
|
|
| Neck Cimrcumferce: Is your neck circumference greater than 40cm/15¾"? |
|
|
| Gender: Are you male? |
|
|
is your score.
Below 3 = low risk. 3 and above = high risk.
Stop Bang Sleep Test Questionnaire: Copyright @ 2012 | www.stopbang.ca | All Rights Reserved Frances Chung MBBS FRCPC |
