Berlin Questionaire

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Question Response

Has your weight changed? Increase
Decreased
No change
Do you snore? Yes
No
Do not Know
Snoring loudness Loud as breathing
Loud as talking
Louder than talking
Very loud
Snoring frequency Almost every day
3 to 4 times per week
1 to 2 times per week
1 to 2 times per month
Never or almost never
Does your snoring bother other people? Yes
No
How often have your breathing pauses been noticed? Almost every day
3 to 4 times per week
1 to 2 times per week
1 to 2 times per month
Never or almost never
Are you tired after sleeping? Almost every day
3 to 4 times per week
1 to 2 times per week
1 to 2 times per month
Never or almost never
Are you tired during waketime? Almost every day
3 to 4 times per week
1 to 2 times per week
1 to 2 times per month
Never or almost never
Have you ever fallen asleep while driving? Yes
No
Do you have high blood pressure? Yes
No
Do not Know

Scoring Categories: Category 1 is positive with 2 or more positive responses to questions 2-6 ??Category 2 is positive with 2 or more positive responses to questions 7-9 ??Category 3 is positive with 1 or more positive responses and/or a BMI>30 ??Final Results: 2 or more positive categories indicates a high likelihood of sleep disordered breathing.

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