Berlin Questionnaire

CATEGORY ONE:

1) Do you snore?

2) How loud is your snoring?

As loud as breathing

As loud as talking

Louder than talking

Loud enough to be heard in the next room

3) How often do you snore?

Nearly every day

3 - 4 × /week

1 - 2 × /week

1 - 2 × /month

Hardly ever

4) Has your snoring ever bothered other people?

5) Has anyone noticed you stop breathing when you are asleep?

Nearly every day

3 - 4 × /week

1 - 2 × /week

1 - 2 × /month

Hardly ever

Category I is positive if any of the above is present.

CATEGORY TWO

1) After sleep, are you fatigued?

3 - 4 × /week

1 - 2 × /week

1 - 2 × /month

Hardly ever

2) While awake, are you fatigued?

3 - 4 × /week

1 - 2 × /week

1 - 2 × /month

Hardly ever

3) Have you ever fallen asleep while driving a vehicle?

Nearly every day

3 - 4 × /week

1 - 2 × /week

1 - 2 × /month

Hardly ever

Category II is positive if any of the above is present.

CATEGORY THREE:

1) Do you have hypertension?

2) Is your BMI > 30?

Category III is positive if any of the above is present

You are at high risk for sleep disorder if two or more categories are positive