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Patient Resources

Locations

Clinical Sleep Centers

Roseville
1130 Conroy Lane, Ste 403
Roseville, CA 95661
916-789-0112

Sacramento
2875 50th Street
Sacramento, CA 95817
916-455-1994

Folsom
1641 Creekside Dr., Ste 200
Folsom, CA 95630
916-235-8530

CPAP Supply & Service Centers

Roseville
1130 Conroy Lane, Ste 401
Roseville, CA 95661
916-789-0112

Sacramento
730 Alhambra Blvd, Ste 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