Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)? No Yes
Do you often feel Tired, Fatigued, or Sleepy during the daytime(such as falling asleep during driving or talking to someone)? No Yes
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep? No Yes
Do you have or are being treated for High Blood Pressure? No Yes
Body Mass Index (BMI) more than 35 kg/m2? Calculate below if unknown. No Yes
Age older than 50 years old? No Yes
Neck size large? (Measured around Adam's apple)For male, is your shirt collar 17 inches/43cm or larger?For female, is your shirt collar 16 inches/41cm or larger? No Yes
Gender = Male? No Yes
Proprietary to University Health Network. www.stopbang.ca Modified from: Chung F et al. Anesthesiology 2008; 108:812-21; Chung F et al. Br J Anaesth 2012, 108:768–75; Chung F et al. J Clin Sleep Med 2014;10:951-8.
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Who should receive these results? Cancel Maj. Smith, LCSW Dr. Webb