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New York
Beth Israel Medical Center

Sleep HealthCenters
Toll Free 1-877-SLEEPHC
FAX 781-271-0601
info@sleephealth.com

SCREENING FOR SLEEP APNEA

The following questions should guide clinical suspicion:

1. Snoring:
a) Do you snore on most nights (more than 3 times/week)?
Yes (2) No (0)

b) Is your snoring loud (can it be heard through a door or
wall)?
Yes (2) No (0)

2. Has it ever been reported to you that you stop breathing
or gasp during sleep?
Never (0) Occasionally (3) Frequently (5)

3. What is your collar size?
Male: less than 17 inches (0) 17 inches or greater (5)
Female: less than 16 inches (0) 16 inches or greater (5)

4. Have you had, or are you currently being treated for, high
blood pressure?
Yes (2) No (0)

5. Do you occasionally doze, or fall asleep during the day
when:
a) You are not busy or active?
Yes (2) No (0)

b) You are driving or stopped at a light?
Yes (2) No (0)

SCORE:

 9 points or more

 6-8 points

5 points or less

Order Sleep study or refer to sleep specialist 

Gray area - use clinical judgment

Low probability of sleep apnea



For Questions and Referrals,
Call Toll Free
1-877-SLEEPHC
(1-877-753-3742)

Developed by David White, Boston, Massachusetts, 1998

OBSTRUCTIVE SLEEP APNEA
Sleep apnea is a common disorder characterized by repetitive
collapse of the pharyngeal airway during sleep.

CONSEQUENCES INCLUDE:
sleep disruption, waking sleepiness, poor job performance, decreased quality of life, and/or increased motor vehicle accidents. In addition, sleep apnea may contribute to systemic hypertension, mild pulmonary hypertension, arrhythmias and, possibly, myocardial infarction & stroke.

DIAGNOSIS:
In a patient with a reasonable probability of sleep apnea, sleep study is indicated. Call Sleep HealthCenters® to make a referral or for more information.

TREATMENT:
For complete testing and treatment options, call:
Toll Free
1-877-SLEEPHC
(1-877-753-3742)

Developed by David White, Boston, Massachusetts, 1998

If you would like to order additional copies of the Sleep Apnea Screening tool, free of charge, to make available to all of your patients, please contact Jennifer Feldman at (617) 527-2227 ext.177.


Click here to download a copy of the sleep apnea screening tool.

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