Berlin Questionnaire

Berlin Questionnaire 2016-11-15T08:39:53+00:00

Category 1

1. Do you snore?

a. Yes

b. No

c. I do not know

2. Your snoring is:

a. slightly louder than breathing

b. as loud as talking

c. louder than talking

d. very loud – can be heard in adjacent rooms

3. How often do you snore?

a. Nearly every day

b. 3-4 times per week

c. 1-2 times per week

d. 1-2 times per month

e. Nearly never

4. Has your snoring ever bothered other people?

a. Yes

b. No

c. I do not know

5. Has anyone noticed that you quit breathing during your sleep?

a. Nearly every day

b. 3-4 times per week

c. 1-2 times per week

d. 1-2 times per month

e. Nearly never

Category 2

6. How often do you feel tired or fatigued after you sleep?

a. Nearly every day

b. 3-4 times per week

c. 1-2 times per week

d. 1-2 times per month

e. Nearly never

7. During your waking time, do you feel tired, fatigued, or not up to par?

a. Nearly every day

b. 3-4 times per week

c. 1-2 times per week

d. 1-2 times per month

e. Nearly never

8. Have you ever nodded off or fallen asleep while driving a vehicle?

a. Yes

b. No

if yes to #8: 9. How often does this occur?

a. Nearly every day

b. 3-4 times per week

c. 1-2 times per week

d. 1-2 times per month

e. Nearly never

Category 3

10. Do you have high blood pressure?

a. Yes

b. No

c. I do not know

Scoring

The questionnaire consists of three categories related to the risk of having sleep apnea. Potential 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, & 5.

#1: if ‘Yes’ is the response, assign 1 point

#2: if ‘c’ or ‘d’ is the response, assign 1 point

#3: if ‘a’ or ‘b’ is the response, assign 1 point

#4: if ‘a’ is the response, assign 1 point

#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.

Category 2: items – 6, 7, & 8, (item #9 should be noted separately).

#6: if ‘a’ or ‘b’ is the response, assign 1 point

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

#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 #10 is ‘Yes’ OR if the Body Mass Index (BMI) of the patient is greater than 30 (BMI must be calculated.)

BMI = (weight x 703) / (height x height)

*Weight in pounds, height in inches OR weight in kilograms, height in meters.