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SLEEP APNEA SCREENER

The STOP-Bang Sleep Apnea Questionnaire is a questionnaire that is designed to help identify people who may be at risk of developing obstructive sleep apnea (OSA). It asks eight simple questions about a person’s snoring, tiredness, and other factors. The answers to these questions are used to calculate a score that indicates the risk of OSA.

Do you snore loudly (louder than talking)? *YesNo

Do you often feel tired, fatigued, or sleepy during daytime? *YesNo

Has anyone observed you stop breathing during your sleep? *YesNo

Do you have or are you being treated for high blood pressure? *YesNo

Is your Body Mass Index (BMI) score higher than 35? *YesNo

Are you over 50 years old? *YesNo

Is your neck circumference bigger than 16 inches (40cm)? *YesNo

Are you male? *YesNo

Do any of the following apply to you?High blood pressureDiabetesHeart diseaseStrokeInsomniaDepressionFrequent nighttime urinationNone of the aboveCheck all that apply.

From a scale of 0 to 8, you have scored:

Lung Sleep Institute Medical Disclaimer *

I acknowledge, the Screener is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Screener.

CONTACT US FOR QUESTIONS OR APPOINTMENTS

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By submitting a form you hereby agree to hold Lung Sleep Institute at Millennium Physician Group, its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties

Contact Us

239-315-7123

239-315-7122 (fax)

6376 Pine Ridge Rd. Unit 440
Naples, Florida 34119

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