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Obstructive Sleep Apnoea

Assessment - Questionnaires

The following questionnaires can be used to identify patients who may have OSA.

The online version of the ESS OSA50 and STOP-Bang can be completed via the links below.

To qualify for a Medicare rebate for a home-based study patients need to

score 8 or more on ESSANDscore 5 or more on OSA50
score 3 or more on STOP-Bang

Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) 1 determines subjective daytime sleepiness by asking individuals to rate their chance of dozing off in eight situations; an ESS of >10 is higher than normal, >16 indicative of pathological daytime sleepiness. The numerical outcome however is not always a reliable measure of the severity of the complaint.2, 3 Some patients may deny or downplay their sleepiness for fear of having their drivers licence restricted; or they may be unaware of the severity of their sleepiness, and not always recognise significant daytime dysfunction.1 Medical history, and in some instances history from a spouse or partner, is best suited to determine the probability of clinically relevant OSA.


The OSA50 questionnaire was developed by Australian sleep medicine researchers and is specifically designed for use in general practice to identify patients at high risk of moderate-severe OSA.4

It consists of 4 items:

1. Obesity (as assessed by waist circumference)

2. Snoring

3. Witnessed Apnoeas

4. Age ≥50 years

An OSA50 score ≥5 points has been found to have 94% sensitivity with 31% specificity for identifying moderate-severe OSA in primary care.5


The STOP-Bang questionnaire comprises 4 questions

  1. Snoring loudly
  2. Tired
  3. Observed stop breathing
  4. high blood Pressure

and 4 examination or demographic features

  1. BMI >35 kg/m2
  2. Age >50 years
  3. Neck size >40cm
  4. male Gender

It can be used to screen for the presence of OSA preoperatively. A score of ≥ 3 points which has high sensitivity.5, 6

Berlin Questionnaire

The Berlin Questionnaire (BQ) is a sleep apnoea screening questionnaire used to identify the low to high risk of sleep disordered breathing. The questionnaire consists of 11 questions and 3 categories. Risk is based on the responses to individual items and overall scores in the symptom categories.7

Insomnia Severity Index

Up to 50% of OSA patients report co-morbid insomnia symptoms that can be managed with non-pharmacological cognitive behavioural treatment for insomnia. The Insomnia Severity Index is a 7-item self-report measure of global insomnia severity. A score of ≥15 indicates ‘clinically significant insomnia’ in the presence of OSA.8, 9, 10


AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset

Quick links


  1. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14(6):540-5
  2. Kapur VK, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2017;13(3):479-504
  3. Turnbull CD, et al. To screen or not to screen for obstructive sleep apnea, that is the question. Sleep Med Rev.2017;36(12):125-7
  4. Chai-Coetzer CL, et al. A simplified model of screening questionnaire and home monitoring for obstructive sleep apnea in primary care. Thorax 2011;66:213-9
  5. Hamilton GS, et al. Update on the assessment and investigation of adult obstructive sleep apnoea. Aust J Gen Pract 2019;48(4):176-81
  6. Chung F, et al. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaest 2012;108:768-7
  7. Hamilton GS, et al. Update on the assessment and investigation of adult obstructive sleep apnoea. Aust J Gen Pract 2019;48(4):176-81Netzer NC, et al. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999;131(7):485-91
  8. Netzer NC, et al. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999;131(7):485-91
  9. Sweetman A, et al. Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with co-morbid insomnia: A randomized clinical trial. Sleep 2019;42(12)
  10. Sweetman A, et al. Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials. Brain Sci 2019;9(12):371