Self Snore Screener1

Signs Your Snoring Needs Help

1. Snoring

Do you snore loudly? Louder than talking or to be heard through closed doors?

Y N

Not only is snoring a nuisance, but 76% of people who snore have Obstructive Sleep Apnea (OSA).

2. Tired

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

Y N

Fatigue that prevents you from doing daily activities is not normal.

3. Observed

Has anyone observed you stop breathing during your sleep?

Y N

People with Sleep Apnea can actually stop breathing hundreds of times throughout the night.

4. Blood Pressure

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

Y N

Sudden drops in blood oxygen levels that occur during pauses in breathing increase blood pressure and puts strain on your heart.

5. BMI

Is your BMI greater than 35? Click here to determine your BMI

Y N

To be physically active, you need to have energy.

6. Age

Are you over 50 years old?

Y N

As you age, hormonal changes and a less active lifestyle increase your risk of obesity.

7. Neck Circumference

Is your neck greater than 40cm (16in)?

Y N

A wide neck circumference is associated with obesity-related conditions such as Sleep Apnea, diabetes and hypertension.

8. Gender

Are you a male?

Y N

Obstructive Sleep Apnea affects 24% of men and 9% of women.

Impact

How much does snoring impact your relationship with your partner? (1 = Not at All, 5 = Significantly Impacting Relationship)

1 Stop Bang Sleep Test Questionnaire: Copyright @ 2012 | www.stopbang.ca | All Rights Reserved Frances Chung MBBS FRCPC

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