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Patient Resources

Locations

Clinical Sleep Centers

Roseville
1130 Conroy Lane, 403
Roseville, CA 95661
916.789.0112

Sacramento
2875 50th Street
Sacramento, CA 95817
916.455.1994

Folsom
1641 Creekside Drive, 200
Folsom, CA 95630
916.235.8530

Placerville
1004 Fowler Way, 6
Placerville, CA 95667
530.303.4004

CPAP Supply & Service Centers

Roseville
1130 Conroy Lane, 401
Roseville, CA 95661
916.789.0112

Sacramento
730 Alhambra Blvd, 222
Sacramento, CA 95816
916.512.1976

STOP-BANG Questionnaire


Height _____ inches/cm Weight _____ lb/kg

Age _____ Male/Female BMI _____

Collar size of shirt: S, M, L, XL, or _____ inches/cm

Neck circumference _____ cm  

1. Snoring:  Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?Yes No

2. Tired:  Do you often feel tired, fatigued, or sleepy during daytime? Yes No

3. Observed:  Has anyone observed you stop breathing during your sleep? Yes No

4. Blood pressure:  Do you have or are you being treated for high blood pressure? Yes No

5. Body Mass Index (BMI):  BMI more than 35 kg/m2? Yes No

6. Age:  Age over 50 yr old? Yes No

7. Neck circumference:  Neck circumference greater than 40 cm? Yes No

8. Gender:  Gender male? Yes No

High risk of OSA: answering yes to three or more items

Low risk of OSA: answering yes to less than three items