Generated Narrative: Questionnaire DHOSleepQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints DHOSleepQuestionnaire The Questionnaire collects patient-reported sleep symptoms, habits, and risk factors to support assessment of sleep disorders such as sleep apnoea. Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOSleepQuestionnaire#1.0 #xD; intro Epworth Scale 0..1 display #xD; patient-details Patient Details 0..1 group #xD; name Name 0..1 string #xD; address Address 0..1 string #xD; nhi NHI 0..1 string #xD; dob Date Completed 0..1 date #xD; measurements Measurements 0..1 group #xD; weight Weight (kg) 0..1 decimal #xD; height Height (cm) 0..1 decimal #xD; neck Neck circumference (cm) - Please use tape measure provided 0..1 decimal #xD; dentures Do you have dentures? (full or partial) 0..1 string #xD; sleep-apnoea Sleep Apnoea 0..1 group #xD; snoring According to what others have told you, how often do you think you snore? 0..1 open-choice Value Set: general-scale #xD; stop-breathing Has anyone heard you stop breathing in your sleep? 0..1 boolean #xD; choking Do you sometimes wake with a choking or gasping sensation? 0..1 boolean #xD; family Does anyone in your family have obstructive sleep apnoea? 0..1 boolean #xD; toilet Do you get up to go to the toilet more than once a night? 0..1 boolean #xD; headache Do you regularly wake with headaches in the morning? 0..1 boolean #xD; daytime Sleepiness during the Day 0..1 group #xD; refreshed Do you wake feeling refreshed? 0..1 choice Value Set: general-scale #xD; sleepy How often do you feel sleepy and want to fall asleep in the daytime? 0..1 choice Value Set: general-scale #xD; epworth Epworth Sleepiness Score 0..1 group #xD; fallasleep How likely are you to doze off or fall asleep in the following situations - in contrast to feeling tired. This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. 0..1 display #xD; sittingandreading Sitting & Reading 0..1 choice Value Set: epworth-sleep-scale #xD; reading Watching TV 0..1 choice Value Set: epworth-sleep-scale #xD; sittingactivity Sitting inactive in a public place (theatre, meeting, etc) 0..1 choice Value Set: epworth-sleep-scale #xD; incarforanhour A passenger in a car for one hour 0..1 choice Value Set: epworth-sleep-scale #xD; lyingdown Lying down in the afternoon (if circumstances permit) 0..1 choice Value Set: epworth-sleep-scale #xD; sittingtalking Sitting talking to someone 0..1 choice Value Set: epworth-sleep-scale #xD; trafficlights In a car whilst stopped in traffic or traffic lights 0..1 choice Value Set: epworth-sleep-scale #xD; medical Medical History 0..1 group #xD; hayfever Hayfever or constantly blocked nose 1..1 boolean #xD; nasal Previous nasal surgery 0..1 boolean #xD; airway Previous airway surgery? (e.g. tonsils removed) 0..1 boolean #xD; heart Heart disease (heart failure, heart attack, angina, arrhythmia e.g. atrial fibrillation, stent or bypass?) 0..1 boolean #xD; bp High blood pressure 0..1 boolean #xD; controldifficulty If yes, is difficult to control? 0..1 boolean Enable When: bp = #xD; stroke Previous stroke or TIA ‘mini-stroke’? 0..1 boolean #xD; diabetes Diabetes 0..1 boolean #xD; yescontroldifficulty If yes, is it difficult to control? 0..1 boolean Enable When: diabetes = #xD; depression Depression 0..1 boolean #xD; depression_11 If yes, is it difficult to control? 0..1 boolean Enable When: depression = #xD; asthma Asthma/COPD 0..1 boolean #xD; neuro Neuromuscular disease 0..1 boolean #xD; epilepsy Epilepsy 0..1 boolean #xD; neurodisease If yes, is it difficult to control? 0..1 string Enable When: epilepsy = #xD; lifestyle Lifestyle 0..1 group #xD; breath Do you get short of breath during your daily activities? 0..1 boolean #xD; occupation What is your Occupation? 0..1 string #xD; job-risk Has your job been at risk due to sleepiness or loss or concentration? 0..1 boolean #xD; doze-driving Do you have a vehicle licence? 0..1 boolean #xD; licenseclass What is your vehicle licence class? 0..1 choice Enable When: doze-driving = Options: 6 options #xD; licenseendorsement What is your vehicle licence endorsement? 0..1 choice Enable When: doze-driving = Options: 9 options #xD; sleep-pattern Restless Legs 0..1 group #xD; sleep-time When you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walkin 0..1 boolean #xD; sleeptime If yes, please describe your symptoms: 0..1 text Enable When: sleep-time = #xD; sleephours Hours of Sleep 0..1 group #xD; wake-time What time do you go to sleep at night? 0..1 time #xD; shift What time do you get up in the morning? 0..1 time #xD; shiftwork Do you do shift work? 0..1 boolean #xD; usualhourswork Please describe your usual hours of work 0..1 text #xD; medications Difficulty Sleeping 0..* string #xD; takelongtosleep How long does it take you to get to sleep? 0..1 string #xD; wakeupatnight How many times do you usually wake up during the night? 0..1 string #xD; backtosleep When you wake up, how long does it usually take you to get back to sleep? 0..1 string #xD; disturbsyoursleep Do you have pain that disturbs your sleep? 0..1 string #xD; othersymptoms Other Symptoms 0..1 string #xD; hallucinations01 Do you have hallucinations (you see, feel or hear things that aren’t there) while falling asleep or waking up? 0..1 boolean #xD; hallucinations02 If yes, please describe your symptoms: 0..1 text Enable When: hallucinations01 = #xD; cannotmove Do you ever feel you can’t move or talk at all for 1 to 2 minutes after you wake up? 0..1 boolean #xD; laughter01 Do you have sudden bouts of muscle weakness brought on by laughter or emotion? 0..1 boolean #xD; laughter02 If yes, please describe your symptoms: 0..1 string Enable When: laughter01 = #xD; sleepdifficulty01 Do you have any other difficulties with sleep, like nightmares, acting out dreams, sleepwalking? 0..1 boolean #xD; sleepdifficulty02 If yes, please describe your symptoms: 0..1 text Enable When: sleepdifficulty01 = #xD; Documentation for this format Options Sets Answer options for licenseclass null#null ("Class 1 (motorcar)") null#null ("Class 2") null#null ("Class 3") null#null ("Class 4") null#null ("Class 5") null#null ("Class 6 (Motorcycle)") Answer options for licenseendorsement null#null ("P") null#null ("V") null#null ("D") null#null ("F") null#null ("R") null#null ("T") null#null ("W") null#null ("I") null#null ("O") Contained Resources ValueSet #epworth-sleep-scale This value set expansion contains 4 concepts. Code System Display 0 0 -- NEVER doze 1 1 -- SLIGHT chance of dozing 2 2.-- MODERATE chance of dozing 3 3 -- HIGH chance of dozing ValueSet #general-scale This value set expansion contains 5 concepts. Code System Display 4 Always 3 Often 2 Sometimes 1 Rarely 0 Never ValueSet #boolen-choice This value set expansion contains 2 concepts. Code System Display Yes No
The Questionnaire collects patient-reported sleep symptoms, habits, and risk factors to support assessment of sleep disorders such as sleep apnoea.
Enables clinicians to evaluate risk and guide further investigation and care.
Neck circumference (cm) - Please use tape measure provided
According to what others have told you, how often do you think you snore?
Has anyone heard you stop breathing in your sleep?
Do you sometimes wake with a choking or gasping sensation?
Does anyone in your family have obstructive sleep apnoea?
Do you get up to go to the toilet more than once a night?
Do you regularly wake with headaches in the morning?
How often do you feel sleepy and want to fall asleep in the daytime?
How likely are you to doze off or fall asleep in the following situations - in contrast to feeling tired. This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you.
Sitting inactive in a public place (theatre, meeting, etc)
Lying down in the afternoon (if circumstances permit)
In a car whilst stopped in traffic or traffic lights
Previous airway surgery? (e.g. tonsils removed)
Heart disease (heart failure, heart attack, angina, arrhythmia e.g. atrial fibrillation, stent or bypass?)
Do you get short of breath during your daily activities?
Has your job been at risk due to sleepiness or loss or concentration?
What is your vehicle licence endorsement?
When you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walkin
Please describe your usual hours of work
How long does it take you to get to sleep?
How many times do you usually wake up during the night?
When you wake up, how long does it usually take you to get back to sleep?
Do you have pain that disturbs your sleep?
Do you have hallucinations (you see, feel or hear things that aren’t there) while falling asleep or waking up?
Do you ever feel you can’t move or talk at all for 1 to 2 minutes after you wake up?
Do you have sudden bouts of muscle weakness brought on by laughter or emotion?
Do you have any other difficulties with sleep, like nightmares, acting out dreams, sleepwalking?