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Home > Occupational Health > Employee Know Before You Go: Before Your Visit > City of Charlottesville > FIRE/EMS: Annual Medical Clearance > Berlin Questionnaire - Sleep Apnea

Berlin Questionnaire - Sleep Apnea

The Berlin Questionnaire consists of 3 categories related to the risk of having sleep apnea.  Individuals 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.

Gender  


Category 1
1. Do you Snore?  



If "no", proceed to question 6. If "yes", please answer questions 2-5 below.
2. Is your snoring:



3. How often do you snore?





4. Has your snoring ever bothered other people?



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





Category 2
6. How often do you feel tired or fatiqued after your sleep?  





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





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


If you answered "yes" to question (8) above, please answer question 9 below.
9. How often does this occur?





Category 3
10. Do you have high blood pressure?