Biron provides you with a screening form to help you find out if you have any sleep problems. Patients can use our simple stop bang questionnaire to help them quickly determine their risk level.
Download 1 minute sleep apnea screening.
Sleep apnea screening forms. By screening every patient for osa we can help them get the treatment they so desperately need. Stop bang sleep apnea questionnaire chung f et al anesthesiology 2008 and bja 2012 stop do you snore loudly louder than talking or loud enough to be heard through closed doors. Click to start the test.
Yes no has anyone observed you stop breathing during your sleep. We could prevent patients from early illness by screening for osa we may be able to preempt hypertension cardiovascular events gerd and diabetes. They may bring their results to an appointment with you to discuss them.
Upon receipt of the referral form we will schedule an appointment with your patient. Get a pen and paper ready to note down your answers to each question. Patients with osa who are diagnosed and treated with either positive airway pressure pap therapy or an alternative treatment can experience improvements in their sleep quality heart health and.
Yes to 3 4 questions osa high risk. Yes to 5 8 questions or yes to 2 or more of 4 stop questions male gender or yes to 2 or more of 4 stop questions bmi 35kg m 2 or yes to 2 or more of 4 stop questions neck circumference 17 inches 43cm in male or 16 inches 41cm in female property of. Fax a referral form to us.
As overnight polysomnography the criterion standard diagnostic test is expensive and limited in its availability many people with osa perhaps as many as 93 remain undiagnosed. This screening form will help you better understand if your patients may. Yes no do you often feel tired fatigued or sleepy during daytime.
Yes to 0 2 questions osa intermediate risk. For general population osa low risk. If the referral is for home sleep testing we will send you the results within 10 days of the test.
Obstructive sleep apnea screening health advisory obstructive sleep apnea osa is a potentially lethal disease that increases the risk of numerous health problems including cardiovascular disease. We also offer a more detailed sleep disorder symptoms assessment for your use with patients complete with a scoring guide. 1 effective screening in primary care settings could increase the number of osa patients identified who can then be offered.
We can save patients lives untreated sleep disordered breathing is associated with increased risk of early death. Identifying patients who are likely to have obstructive sleep apnea osa is vital. Screening questionnaire this sleep apnea screener features the stop bang questionnaire and epworth sleepiness scale to help you gauge your risk for sleep apnea.
