Screening Questionnaire
Screening
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For general population
OSA – Low Risk: Yes to 0 – 2 questions
OSA – Intermediate Risk: Yes to 3 – 4 questions
OSA – High Risk: Yes to 5 – 8 questions or
Yes to 2 or more of 4 STOP questions + male gender or
Yes to 2 or more of 4 STOP questions + BMI > 35kg/m2 or
Yes to 2 or more of 4 STOP questions + neck circumference 17 inches / 43cm in male or 16 inches / 41cm in female
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Question 1 of 8
1. Question
Snoring?
Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?Correct
Incorrect
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Question 2 of 8
2. Question
Tired ?
Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?Correct
Incorrect
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Question 3 of 8
3. Question
Observed ?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep ?Correct
Incorrect
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Question 4 of 8
4. Question
Pressure ?
Do you have or are being treated for High Blood Pressure ?Correct
Incorrect
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Question 5 of 8
5. Question
BMI
Body Mass Index more than 35 kg/m2?
Calculate your bMICorrect
Incorrect
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Question 6 of 8
6. Question
Age older than 50 ?
Correct
Incorrect
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Question 7 of 8
7. Question
Neck size large ? (Measured around Adams apple)
For male, is your shirt collar 17 inches / 43cm or larger?
For female, is your shirt collar 16 inches / 41cm or larger?Correct
Incorrect
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Question 8 of 8
8. Question
Gender = Male ?
Correct
Incorrect
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