STOP-BANG Sleep Apnea Questionnaire

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Name(Required)

First Last

Email(Required)

Phone(Required)

Height (in cm)(Required)

Weight (in Pound)(Required)

Age(Required)

Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?(Required)

Yes

Do you often feel TIRED, fatigued, or sleepy during daytime?(Required)

Yes

Has anyone OBSERVED you stop breathing during your sleep?(Required)

Yes

Do you have or are you being treated for high blood PRESSURE?(Required)

Yes

BMI more than 35kg/m2 ?(Required)

Yes

AGE over 50 years old ?(Required)

Yes

NECK circumference > 16 inches (40cm) ?(Required)

Yes

Gender : Male?(Required)

Yes

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Result

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