Do I have Sleep Apnea? – Screening Questionnaire

This sleep apnea screener features the STOP BANG questionnaire and Epworth Sleepiness Scale to help you gauge your risk for sleep apnea. Get a pen and paper ready to note down your answers to each question. Talk to  your doctor about your results.

STOP BANG

(Answer yes or no for each question)

  • S (snore)
    Do you snore?
  • T (tired)
    Do you feel fatigued during the day?
    Do you wake up feeling like you haven’t slept?
  • O (obstruction)
    Have you been told you stop breathing at night?
    Do you gasp for air or choke while sleeping?
  • P (pressure)
    Do you have high blood pressure or are on
    medication to control high blood pressure?

SCORE: If you checked YES to two or more questions on the STOP portion you are at risk for OSA.

  • B (BMI)
    Is your body mass index greater than 28?
  • A (age)
    Are you 50 years old or older?
  • N (neck)
    Are you a male with neck circumference greater than 17 inches, or a female with neck circumference greater than 16 inches?
  • G (gender)
    Are you a male?

SCORE: The more questions you checked YES to on the BANG portion, the greater your risk of having moderate to severe OSA.

Epworth

(Rate 0 – 3 for each scenario)

How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing

  • Sitting and reading
  • Watching TV
  • Sitting inactive in a public place (e.g. a theater or a meeting)
  • Sitting in a car as a passenger for a continuous hour
  • Lying down to rest in the afternoon when circumstances permit
  • Sitting and talking to someone
  • Sitting quietly after a lunch without alcohol
  • Sitting in a car stopped in traffic for a few minutes

SCORE: Add up your score for each scenario. 0–10 Normal range | 10–12 Borderline | 12–24 Sleepy