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Survey - Didge For Sleep
Fill out this survey before you start playing, after playing for 6 weeks and again after playing for 12 weeks. Known as the STOP BANG questionnaire, this survey is one of the most highly used sleep apnea assessment tools.
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* Indicates required question
Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?
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Yes
No
Do you often feel tired, fatigued, or sleepy during the daytime?
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Yes
No
Has anyone observed you stop breathing during your sleep?
*
Yes
No
Do you have or are you being treated for high blood pressure?
*
Yes
No
Body Mass Index calculator (for the following question):
https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
Is your Body Mass Index greater than 35kg/m2?
*
Yes
No
Are you age 50 or over?
*
Yes
No
Is your neck circumference greater than 16 inches (40cm)? Use a measuring tape to find out.
*
Yes
No
Are you male?
*
Yes
No
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
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