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    Berlin Questionnaire: Sleep Apnea

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    muhammad fikra triwijaya
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    Berlin Questionnaire: Sleep Apnea

    Uploaded by

    muhammad fikra triwijaya
    38 views3 pages
    1

    Original Title

    Berlin Questionnaire

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    38 views3 pages

    Berlin Questionnaire: Sleep Apnea

    Uploaded by

    muhammad fikra triwijaya
    1

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 3

    Berlin Questionnaire©

    Sleep Apnea
    Height (m) ______ Weight (kg) ______ Age ______ Male / Female

    Please choose the correct response to each question.


    During
    Category 1 How often your
    do you waking
    1. Do you snore? feel tired time, do
    or fatigued you feel
    a. Yes after your tired,
    sleep? fatigued or
    b. No □ a. not up to
    c. Don’t know Almost par?
    every day
    If you answered ‘yes’: □ b. 3-4 □ a. Almost
    times per every day
    week □ c. □ b. 3-4
    1-2 times times per
    2. You snoring is:
    per week week □ c.
    □ d. 1-2 1-2 times
    a. Slightly louder than breathing times per per week □
    month d. 1-2
    b. As loud as talking times per
    □ e. month
    c. Louder than talking Rarely or
    never □ e. Rarely
    Category 2 or never
    oth Has ep? you ever
    How often do you er any a. Almost nodded off
    snore? pe one every day or fallen
    opl noti b. 3-4 asleep
    a. Almost every e? ced times per while
    day a. that week driving a
    b. 3-4 times per Yes you c. 1-2 vehicle?
    week b. sto times per a. Yes
    c. 1-2 times per No p week b. No
    week bre
    c. athi d. 1-2 If you
    d. 1-2 times per Do ng times per answered
    month n’t duri month ‘yes’:
    e. Rarely or never kno ng □ e. Rarely
    w you or never 9. How
    Has your snoring r often
    ever bothered sle 8. Have does this
    occur? we mo
    ek nth Category Yes
    a. Almost every e. 3
    day d. Rar No
    1-2 ely 10. Do you Don’t know
    b. 3-4 times per tim or have high
    week es nev blood
    c. 1-2 times per per er pressure?
    Scoring Berlin Questionnaire

    The questionnaire consists of 3 categories related to the risk of having sleep


    apnea. Patients can be classified into High Risk or Low Risk based on their
    responses to the individual items and their overall scores in the symptom
    categories.

    Categories and Scoring: Category 1: items 1, 2, 3, 4, and 5; Item 1: if ‘Yes’,


    assign 1 point
    Item 2: if ‘c’ or ‘d’ is the response, assign 1 point Item 3: if ‘a’ or ‘b’ is the response,
    assign 1 point Item 4: if ‘a’ is the response, assign 1 point
    Item 5: if ‘a’ or ‘b’ is the response, assign 2 points
    Add points. Category 1 is positive if the total score is 2 or more points.

    Category 2: items 6, 7, 8 (item 9 should be noted separately). Item 6: if ‘a’ or ‘b’


    is the response, assign 1 point
    Item 7: if ‘a’ or ‘b’ is the response, assign 1 point
    Item 8: if ‘a’ is the response, assign 1 point

    Add points. Category 2 is positive if the total score is 2 or more points.

    Category 3 is positive if the answer to item 10 is ‘Yes’ or if the BMI of the patient
    is greater than 30kg/m2.
    (BMI is defined as weight (kg) divided by height (m) squared, i.e.., kg/m 2).

    High Risk: if there are 2 or more categories where the score is positive.

    Low Risk: if there is only 1 or no categories where the score is positive.

    Additional Question: item 9 should be noted separately.

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