STOP-BANG Sleep Apnea Questionnaire
[Pages:1]Name _________________________________ Height ___________ Weight _________ Age __________ Male / Female ___________
STOP-BANG Sleep Apnea Questionnaire
Chung F et al Anesthesiology 2008 and BJA 2012
STOP
Do you SNORE loudly (louder than talking or loud
Yes
No
enough to be heard through closed doors)?
Do you often feel TIRED, fatigued, or sleepy during
Yes
No
daytime?
Has anyone OBSERVED you stop breathing during
Yes
No
your sleep?
Do you have or are you being treated for high blood
Yes
No
PRESSURE?
BANG
BMI more than 35kg/m2? AGE over 50 years old? NECK circumference > 16 inches (40cm)? GENDER: Male?
Yes
No
Yes
No
Yes
No
Yes
No
TOTAL SCORE
High risk of OSA: Yes 5 - 8 Intermediate risk of OSA: Yes 3 - 4 Low risk of OSA: Yes 0 - 2
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- 2017 form 1040 internal revenue service
- public service loan forgiveness employment certification
- ira required minimum distribution worksheet
- application for social security card
- by order of the air force instruction 36 2110
- u s department of labor wage and hour division
- stop bang sleep apnea questionnaire
- leave request form authorization united states navy
- aid codes master chart aid codes medi cal
- state operations manual