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    Berlin Questionnaire: Sleep Apnea

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    sulis
    alat ukur OSA yang murah dan mudah, tepat.

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    Berlin Questionnaire: Sleep Apnea

    Uploaded by

    sulis
    141 views2 pages
    alat ukur OSA yang murah dan mudah, tepat.

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    berlin-questionnaire

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    alat ukur OSA yang murah dan mudah, tepat.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    141 views2 pages

    Berlin Questionnaire: Sleep Apnea

    Uploaded by

    sulis
    alat ukur OSA yang murah dan mudah, tepat.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Berlin Questionnaire©

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

    Please choose the correct response to each question.

    Category 1 Category 2

    1. Do you snore? 6. How often do you feel tired or


    □ a. Yes fatigued after your sleep?
    □ b. No □ a. Almost every day
    □ c. Don’t know □ b. 3-4 times per week
    □ c. 1-2 times per week
    If you answered ‘yes’: □ d. 1-2 times per month
    □ e. Rarely or never

    2. You snoring is: 7. During your waking time, do you


    □ a. Slightly louder than breathing feel tired, fatigued or not up to
    □ b. As loud as talking par?
    □ c. Louder than talking □ a. Almost every day
    □ b. 3-4 times per week
    □ c. 1-2 times per week
    □ d. 1-2 times per month
    □ e. Rarely or never

    3. How often do you snore? 8. Have you ever nodded off or fallen asleep
    □ a. Almost every day while driving a vehicle?
    □ b. 3-4 times per week □ a. Yes
    □ c. 1-2 times per week □ b. No
    □ d. 1-2 times per month
    □ e. Rarely or never If you answered ‘yes’:

    4. Has your snoring ever bothered 9. How often does this occur?
    other people? □ a. Almost every day
    □ a. Yes □ b. 3-4 times per week
    □ b. No □ c. 1-2 times per week
    □ c. Don’t know □ d. 1-2 times per month
    □ e. Rarely or never

    5. Has anyone noticed that you stop breathing Category 3


    during your sleep?
    □ a. Almost every day 10. Do you have high blood
    □ b. 3-4 times per week pressure?
    □ c. 1-2 times per week □ Yes
    □ d. 1-2 times per month □ No
    □ □ e. Rarely or never □ Don’t know
    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/m2).

    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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