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Self Evaluation


Self Evaluation

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  • Self Evaluation
  • BMI
  • Berlin Scale
  • Epworth Scale
  • Stopbang Quiz
  • Videos


The Safety First Sleep Apnea Self Evaluation tools are available to help rule out if you may or may not be a candidate for Sleep Apnea. After taking the self evaluation, and you think you have tested positive for sleep apnea, you should contact one of our trained sleep apnea technicians or your physician to further qualify and diagnose and determine the proper treatment for your sleep apnea condition.

Check out our FAQs Page for additional Sleep Apnea information and Health Conditions.

Body Mass Index

Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.

Click here to view and download the BMI Chart.

Berlin Score

This is a very common screening tool that is used to determine levels of daytime sleepiness and sleep debt. The questionnaire may be completed be either the patient and/or spouse and is designed to give an indication whether further investigations are necessary (i.e. referral to a Sleep Specialist.

You can view your score without submitting the form. However, by submitting the form and including your name and phone number, a trained specialist will be in touch with you for the best recommendations.

Answer ALL questions with the best answer that applies.

1. Body Mass Index Information:
Height (in inches):
Weight (in pounds):

CATEGORY 1 QUESTIONS
2. Do you snore?
Yes
No
I don't know

3. How loud is your snoring?
My snoring is as loud as breathing
My snoring is as loud as talking
My snoring is louder than talking
My snoring is very loud

4. How frequently do you snore?
Almost every day
3 - 4 times per week
1 - 2 times per week
1 - 2 times per month
Never or almost never

5. Does your snoring bother other people?
Yes
No

6. How often have your breathing pauses been noticed?
Almost every day
3 - 4 times per week
1 - 2 times per week
1 - 2 times per month
Never or almost never

CATEGORY 2 QUESTIONS
7. Are you tired after sleeping?
Almost every day
3 - 4 times per week
1 - 2 times per week
1 - 2 times per month
Never or almost never

8. Are you tired during waketime?
Almost every day
3 - 4 times per week
1 - 2 times per week
1 - 2 times per month
Never or almost never

9. How often do you nod off or fall asleep while driving?
Almost every day
3 - 4 times per week
1 - 2 times per week
1 - 2 times per month
Never or almost never

CATEGORY 3 QUESTIONS
10. Do you have high blood pressure?
Yes
No
I don't know


Sleep Apnea Scoring Results:  

Note: You test positive in any category with a score of 2 or more.

2 or more categories indicates a high likelihood of sleep apnea.

Category 1 (Snoring) is positive with 2** or more positive responses
Category 2 (Sleepiness) is positive with 2** or more positive responses
Category 3 (BMI/BP) is positive with 1** or more positive responses and/or a BMI>30 
 = Body Mass Index (Compare BMI Index # with chart below)

BMI Rating:
Below 18.5 Underweight
18.5 - 24.9 Normal
25 - 29.9 Overweight
30.0 & Above Obese

RESULTS
** 2 or more positive categories indicates a high likelihood of sleep apnea. Your results are indicated in the colored boxes above.


* You must enter your name, phone and email address for us to contact you. We also respect your privacy and will only use this information to contact you regarding sleep apnea solutions. You do not need to click the submit button unless you wish to have a trained specialist contact you.

Enter your first and last name *:

Enter your phone number *:

Enter your email address *:


For security, please use this code in box below. Click reload image if code is not readable.
CAPTCHA Image
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Verify code in this box. Click Submit button to send.

  

Epworth Scale

The Epworth Scale is an eight-question assessment of daytime sleepiness in which the respondent rates how likely one is to fall asleep in a variety of situations. Scores less than 10 are normal, and scores higher than 10 may suggest the need for additional evaluation by a sleep specialist. The total score can range from 0-24, and higher scores are correlated with increased sleepiness. The average score amongst healthy adults is six. In general, scores higher than ten indicate excessive sleepiness.

Answer ALL questions with the best answer that applies.
Epworth Sleep Test
In the following situations...How likely are you to fall asleep?...
Use the following scale:
"0" = Would never doze or sleep.
"1" = Slight chance of dozing or sleeping.
"2" = Moderate chance of dozing or sleeping.
"3" = High chance of dozing or sleeping.
Click on the appropriate answer:
1. Sitting & Reading?
0
1
2
3
2. Watching TV?
0
1
2
3
3. Sitting inactive in a public place?
0
1
2
3
4. Being a passenger in a motor vehicle for an hour or more?
0
1
2
3
5. Laying down in the afternoon?
0
1
2
3
6. Sitting and talking to someone?
0
1
2
3
7. Sitting quietly after lunch (no alcohol)?
0
1
2
3
8. Stopped for a few minutes in traffic while driving?
0
1
2
3

Epworth Scoring Results:  

Your total Epworth Score


RESULTS
Check the number in the blue box above.
You test positive if your score 9 or more.



* You must enter your name, phone and email address for us to contact you. We also respect your privacy and will only use this information to contact you regarding sleep apnea solutions. You do not need to click the submit button unless you wish to have a trained specialist contact you.

Enter your first and last name *:

Enter your phone number *:

Enter your email address *:


For security, please use this code in box below. Click reload image if code is not readable.
CAPTCHA Image
[ Reload Image ]

Verify code in this box. Click Submit button to send.

  

S.T.O.P.G.A.N.G. Questionaire

The S.T.O.P.G.A.N.G questionaire is another tool used to screen individuals for Obstructive Sleep Apena (OSA).
S = Snoring
T = Tired
O = Observed
P = Pressure
B = Body Mass
A = Age
N = Neck Size
G = Gender

Answer ALL questions with the best answer that applies.
S.T.O.P.B.A.N.G. Sleep Test
S.T.O.P
Click on the appropriate answer:
1. Do you SNORE loudly? (Louder than talking or loud enough to be heard through closed doors)
Yes
No
2. Do you often feel TIRED? (Fatiqued or sleepy during daytime hours)
Yes
No
3. Has anyone OBSERVED you stop breathing during your sleep?
Yes
No
4. Do you have or are you being treated for High Blood PRESSURE?
Yes
No
B.A.N.G.
Click on the appropriate answer:
5. Is your BMI more than 35kg/m2?
Yes
No

6. AGE over 50 years old?
Yes
No
7. NECK circumfrence greater than 15.75 inches (40cm)?
Yes
No
8. Male GENDER?
Yes
No

Number of YES amswers

RESULTS
Check the number in the blue box above.
More than 3 YES answers = High Risk for OSA
Less than 3 YES answers = Low Risk for OSA

* You must enter your name, phone and email address for us to contact you. We also respect your privacy and will only use this information to contact you regarding sleep apnea solutions. You do not need to click the submit button unless you wish to have a trained specialist contact you.

Enter your first and last name *:

Enter your phone number *:

Enter your email address *:


For security, please use this code in box below. Click reload image if code is not readable.
CAPTCHA Image
[ Reload Image ]

Verify code in this box. Click Submit button to send.

  

Product Videos

To view specific product videos click on manufacturer links at right
  • Sleep Apnea Videos
• ARES Videos
• Resmed Videos
• Respironics videos
• Philips Respironics
• Fisher-Paykel
     
     
     
     

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