睡眠呼吸障礙評估問卷
睡眠呼吸障礙評估問卷
Sleep-Disordered Breathing Assessment Questionnaire
患者姓名 / Patient Name:
日期 / Date:
請選擇最適合您情況的選項。 Please select the option that best describes your situation.
0 = 從不 / Never, 1 = 偶爾 / Occasionally, 2 = 經常 / Often, 3 = 總是 / Always
-
您是否經歷在睡眠中感到嗆到或大力喘氣?
Do you experience choking or gasping during sleep? -
睡眠時您是否感到呼吸不順暢或不夠氣?
Do you feel your breathing is labored or short of breath during sleep? -
您是否有鼻鼾?
Do you snore? -
您是否經常在夜間醒來?
Do you frequently wake up during the night? -
您是否有晨起頭痛的情況?
Do you experience morning headaches? -
您白天是否感到疲勞?
Do you feel fatigued during the day? -
您是否感到注意力難以集中?
Do you have difficulty concentrating? -
您是否容易感到容易生氣或煩躁?
Do you feel easily irritable or moody? -
這些症狀是否影響您的日常功能和工作表現?
Do these symptoms affect your daily functions and work performance? -
您是否因為疲勞/嗜睡而感到有安全隱憂(如行走,開車,操作機器時)?
Do you have safety concerns due to fatigue/sleepiness (e.g., while walking, driving, operating machinery)? -
您的伴侶或家人是否觀察到您每晚睡眠中有超過5次睡眠暫停且每次暫停至少10秒的情況?
Has your partner or family observed more than 5 sleep pauses lasting at least 10 seconds each night during your sleep? -
您是否曾經使用CPAP 機器(睡眠時戴上口鼻正壓呼吸機)來改善睡眠障礙症狀?
Have you ever used a CPAP machine to improve sleep disorder symptoms? -
您是否對睡眠時戴住CPAP (正壓呼吸機)感到抗拒或不耐受?
Do you feel resistant or intolerant to wearing a CPAP during sleep?
Epworth 嗜睡量表 (ESS) / Epworth Sleepiness Scale (ESS)
在以下情況下,您有多大可能打盹或睡著?請使用以下評分標準:
How likely are you to doze off or fall asleep in the following situations? Use the following scale:
0 = 從不打盹 / Would never doze
1 = 偶爾打盹 / Slight chance of dozing
2 = 經常打盹 / Moderate chance of dozing
3 = 總是打盹 / High chance of dozing
總分 / Total Score: 0 / 24
0-5: 正常 / Normal
6-10: 輕度 / Mild
11-15: 中度 / Moderate
16-24: 嚴重 / Severe