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Screening Questionnaire

The STOP-BANG Questionnaire is commonly used to screen for obstructive sleep apnea. Answer the eight questions below to assess your risk of sleep apnea. Your responses will only be used to provide you with the result of this screening, and will not be stored.

1. Do you Snore Loudly (loud enough to be heard through closed doors or your bed partner elbows you for snoring at night)?

2. Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving)?

3. Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

4. Do you have or are you being treated for High Blood Pressure?

5. Is your Body Mass Index (BMI) more than 35?

6. Are you older than 50 years of age?

7. Is your neck size large?

Male: answer "yes" if your shirt collar or neck circumference is 17" or larger. Female: answer "yes" if your shirt collar or neck circumference is 16" or larger.

8. Is your gender male?