Online Screening Test | CPAP Machine Sales

Part 2 of 2: OSA Questionnaire

The following questions were pioneered by the University Health Network and follow the STOP-BANG format.

On average, how many hours of sleep do you get?*

Less than 3 Hours
3 - 6 Hours
6 - 8 Hours
Over 8 Hours

Do you often snore loudly?*

loud enough to be heard through closed doors

Yes
No

Do you often feel Tired, Fatigued, or Sleepy during the daytime?*

e.g. falling asleep while driving or talking to someone

Yes
No

Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?*

Yes
No

Do you have or are being treated for High Blood Pressure?*

Yes
No

Is your neck size large? (Measured around Adams apple)*

For male, is your shirt collar 17 inches/ 43cm or larger?
For female, is your shirt collar 16 inches / 41cm or larger?

Yes
No

What is your gender?*

On average, Males are more likely to have sleep apnoea.

Male
Female

Are you older than 50?*

Yes
No

BMI Calculation

Height (cm)*

Weight (Kg)*

BMI*

Height division

Patient Results

First Name*

Last Name*

Email*

You will receive an email with your test results.

Phone (optional)

Sleep Test Reference Code

Epworth Result

Epworth Calculated Result

Epworth Risk Factor

STOP Result

BANG Result

STOPBANG Result

STOPBANG Risk Factor

CPAP Machine Sales Online Sleep Test Result

CPAP Machine Sales
Online Sleep Apnoea Test

Part 1 of 2: Epworth Sleepiness Scale

Part 2 of 2: OSA Questionnaire

BMI Calculation

Patient Results

CPAP Machine SalesOnline Sleep Apnoea Test

Part 1 of 2: Epworth Sleepiness Scale

Part 2 of 2: OSA Questionnaire

BMI Calculation

Patient Results

CPAP Machine Sales
Online Sleep Apnoea Test