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Bed Partner Questionnaire

 

The following questions relate to the behavior that you have observed in your bed partner while he/she is asleep. Use the following scale and choose the most appropriate number for each situation.


0=Never
1=Infrequently (1 night per week)
2=Frequently (2-3 nights per week)
3=Most of the time (4 or more nights per week)

  • Loud, irritating snoring ______
  • Choking or gasping for air _______
  • Stops breathing _______
  • Twitching / kicking of arms or legs _______
  • Snoring requiring separate bedrooms _______
  • Falling asleep inappropriately (example: while driving or at meetings)_______

Total score ______

 

A score of 5 or greater indicates symptoms of Obstructive Sleep Apnea (OSA) which are affecting the health, safety, and/or quality of life of the observed person.  Your bed partner's OSA is also affecting your quality of life as well.  Getting help for your bed partner may be the best thing you can do for your on health.

 

 Back to Obstructive Sleep Apnea (OSA)

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6842 Douglas Boulevard, Suite K
Douglasville, Georgia 30135
Phone: 770-949-1005
Fax: 770.949.1006
Email: info@DrJoeHair.com

Dr. Hair is a Douglasville general and cosmetic dentist who welcomes new patients from all over the Atlanta area, including Douglasville, Villa Rica, Carrollton, Breman, Hiram, Dallas, Lithia Springs, and Newnan. He provides Bed Partner Questionnaire and hospital dentistry in his modern Douglasville, Georgia dental office. He uses some of the newest diagnostic equipment including laser cavity detection and digital x-rays.


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