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Sleep Apnea Self-Assessment - STOP-BANG Questionnaire

The following questionnaire will help you measure your general level of daytime sleepiness. You are to rate the chance that you would doze off or fall asleep during different routine daytime situations. Each item is rated from "No Chance"to "High Chance", meaning the chance that you would doze or fall asleep in that situation.

 
First Name: Last Name:
Email: Phone:
Age: Gender:
 

How likely are you dozing off or falling asleep in the following situations in contrast to just feeling tired?

 
NO
YES

Snoring?

Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner
elbows you for snoring at night)?


Tired?

Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep
during driving or talking to someone)?

Observed?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?
Pressure?
Do you have or are being treated for High Blood Pressure?
Body Mass Index more than 35 kg/m2?
Neck size large? (Measured around Adams apple)
For male, is your shirt collar 17 inches/43 cm or larger?
For female, is your shirt collar 16 inches/41 cm or larger?
   
  
Enter Verification Code   
By clicking on "Score" You allow us to calculate the scoring and provide known interpretation of the score based on the literature.
You also allow us to contact You with additional information to help You keeping a good health. The information You provide us will never shared with any 3rd party or used for inappropriate manner.
Note: This scale should not be used to make your own diagnosis. It is intended as a tool to help you identify the level of daytime sleepiness, which is symptom of many sleep disorders. This page is for information purpose only and is not intended to replace the advice of a qualified health professional. Please contact CPAP Clinic or call 1-877-430-CPAP(2727) with any question.
It is important to remember than true excessive daytime sleepiness is almost always caused by an underlying medical condition that can be easily diagnosed and effectively treated.
 

Locations &
Store Hours

Mon-Fri:

9am-9pm

Saturday:

10am-3pm

* 6200 Dixie Rd., Unit #102 Mississauga, ON, L5T 2E1


---------------------------------------

Mon-Fri:

9am-7pm

Saturday:

10am-3pm

Sunday:

CLOSED

* 1110 Sheppard Ave East, Unit #13 Toronto, ON, M2K 2W2

* 644 Millway Ave, Unit #4 Vaughan, ON, L4K 4H4

Online: 24/7 - Order Anytime

STOP Snoring!

Stop Snoring

Don't Ignore the Snoring...
Do You Snore? Are you always tired? ... it's time to assess your Sleep Apnea

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644 Millway Ave., #4 Vaughan, L4K 4H4

 | 

1110 Sheppard Ave.E., #13 Toronto, M2K 2W2

 | 

6200 Dixie Rd, #102 Mississauga, L5T 2E1

 | 

115 Bell Farm Rd., #107, Barrie, L4M 5G1

905-669-2232

 | 

416-792-2727

 | 

905-564-6000

 | 

705-999-2727


Phone: 1-877-430-2727

 | 

info@cpapclinic.ca

 | 

www.CPAPclinic.ca

 | 

Fax: 1-888-477-7739