DHOSleepQuestionnaire
type: Questionnaire
node role: treeRoot
id:
  v: DHOSleepQuestionnaire
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire DHOSleepQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> 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 i…
contained: ValueSet
  id:
    v: epworth-sleep-scale
  status:
    v: draft
  date:
    v: 2026-04-14T02:03:51.418Z
  expansion:
    timestamp:
      v: 2026-04-14T02:03:49.587Z
    contains:
      code:
        v: 0
      display:
        v: 0 -- NEVER doze
    contains:
      code:
        v: 1
      display:
        v: 1 -- SLIGHT chance of dozing
    contains:
      code:
        v: 2
      display:
        v: 2.-- MODERATE chance of dozing
    contains:
      code:
        v: 3
      display:
        v: 3 -- HIGH chance of dozing
contained: ValueSet
  id:
    v: general-scale
  status:
    v: draft
  date:
    v: 2026-04-14T02:08:31.235Z
  expansion:
    timestamp:
      v: 2026-04-14T02:08:29.128Z
    contains:
      code:
        v: 4
      display:
        v: Always
    contains:
      code:
        v: 3
      display:
        v: Often
    contains:
      code:
        v: 2
      display:
        v: Sometimes
    contains:
      code:
        v: 1
      display:
        v: Rarely
    contains:
      code:
        v: 0
      display:
        v: Never
contained: ValueSet
  id:
    v: boolen-choice
  status:
    v: draft
  date:
    v: 2026-04-14T02:10:27.587Z
  expansion:
    timestamp:
      v: 2026-04-14T02:10:26.293Z
    contains:
      display:
        v: Yes
    contains:
      display:
        v: No
url:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOSleepQuestionnaire
version:
  v: 1.0
name:
  v: DHOSleepQuestionnaire
title:
  v: Sleep Questionnaire
status:
  v: active
subject type:
  v: Patient
date:
  v: 2026-04-16T21:32:31+00:00
publisher:
  v: Te Whatu Ora
contact:
  name:
    v: Te Whatu Ora
  telecom:
    system:
      v: url
    value:
      v: https://www.tewhatuora.govt.nz/
contact:
  name:
    v: Te Whatu Ora Integration Team
  telecom:
    system:
      v: email
    use:
      v: work
description:
  v: The Questionnaire collects patient-reported sleep symptoms, habits, and risk factors to support assessment of sleep disorders such as sleep apnoea.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: NZ
    display:
      v: New Zealand
purpose:
  v: Enables clinicians to evaluate risk and guide further investigation and care.
item:
  link id:
    v: intro
  text:
    v: Epworth Scale
  type:
    v: display
item:
  link id:
    v: patient-details
  text:
    v: Patient Details
  type:
    v: group
  item:
    link id:
      v: name
    text:
      v: Name
    type:
      v: string
  item:
    link id:
      v: address
    text:
      v: Address
    type:
      v: string
  item:
    link id:
      v: nhi
    text:
      v: NHI
    type:
      v: string
  item:
    link id:
      v: dob
    text:
      v: Date Completed
    type:
      v: date
item:
  link id:
    v: measurements
  text:
    v: Measurements
  type:
    v: group
  item:
    link id:
      v: weight
    text:
      v: Weight (kg)
    type:
      v: decimal
  item:
    link id:
      v: height
    text:
      v: Height (cm)
    type:
      v: decimal
  item:
    link id:
      v: neck
    text:
      v: Neck circumference (cm) - Please use tape measure provided
    type:
      v: decimal

link id:
  v: dentures
text:
  v: Do you have dentures? (full or partial)
type:
  v: string

link id:
  v: sleep-apnoea
text:
  v: Sleep Apnoea
type:
  v: group
item:
  link id:
    v: snoring
  text:
    v: According to what others have told you, how often do you think you snore?
  type:
    v: open-choice
  answer value set:
    v: #general-scale
item:
  link id:
    v: stop-breathing
  text:
    v: Has anyone heard you stop breathing in your sleep?
  type:
    v: boolean
item:
  link id:
    v: choking
  text:
    v: Do you sometimes wake with a choking or gasping sensation?
  type:
    v: boolean
item:
  link id:
    v: family
  text:
    v: Does anyone in your family have obstructive sleep apnoea?
  type:
    v: boolean
item:
  link id:
    v: toilet
  text:
    v: Do you get up to go to the toilet more than once a night?
  type:
    v: boolean
item:
  link id:
    v: headache
  text:
    v: Do you regularly wake with headaches in the morning?
  type:
    v: boolean

link id:
  v: daytime
text:
  v: Sleepiness during the Day
type:
  v: group
item:
  link id:
    v: refreshed
  text:
    v: Do you wake feeling refreshed?
  type:
    v: choice
  answer value set:
    v: #general-scale
item:
  link id:
    v: sleepy
  text:
    v: How often do you feel sleepy and want to fall asleep in the daytime?
  type:
    v: choice
  answer value set:
    v: #general-scale

link id:
  v: epworth
text:
  v: Epworth Sleepiness Score
type:
  v: group
item:
  link id:
    v: fallasleep
  text:
    v: 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.
  type:
    v: display
item:
  link id:
    v: sittingandreading
  text:
    v: Sitting & Reading
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: reading
  text:
    v: Watching TV
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: sittingactivity
  text:
    v: Sitting inactive in a public place (theatre, meeting, etc)
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: incarforanhour
  text:
    v: A passenger in a car for one hour
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: lyingdown
  text:
    v: Lying down in the afternoon (if circumstances permit)
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: sittingtalking
  text:
    v: Sitting talking to someone
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale
item:
  link id:
    v: trafficlights
  text:
    v: In a car whilst stopped in traffic or traffic lights
  type:
    v: choice
  answer value set:
    v: #epworth-sleep-scale

link id:
  v: medical
text:
  v: Medical History
type:
  v: group
item:
  link id:
    v: hayfever
  text:
    v: Hayfever or constantly blocked nose
  type:
    v: boolean
  required:
    v: true
item:
  link id:
    v: nasal
  text:
    v: Previous nasal surgery
  type:
    v: boolean
item:
  link id:
    v: airway
  text:
    v: Previous airway surgery? (e.g. tonsils removed)
  type:
    v: boolean
item:
  link id:
    v: heart
  text:
    v: Heart disease (heart failure, heart attack, angina, arrhythmia e.g. atrial fibrillation, stent or bypass?)
  type:
    v: boolean
item:
  link id:
    v: bp
  text:
    v: High blood pressure
  type:
    v: boolean
  item:
    link id:
      v: controldifficulty
    text:
      v: If yes, is difficult to control?
    type:
      v: boolean
    enable when:
      question:
        v: bp
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: all
item:
  link id:
    v: stroke
  text:
    v: Previous stroke or TIA ‘mini-stroke’?
  type:
    v: boolean
item:
  link id:
    v: diabetes
  text:
    v: Diabetes
  type:
    v: boolean
  item:
    link id:
      v: yescontroldifficulty
    text:
      v: If yes, is it difficult to control?
    type:
      v: boolean
    enable when:
      question:
        v: diabetes
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
item:
  link id:
    v: depression
  text:
    v: Depression
  type:
    v: boolean
  item:
    link id:
      v: depression_11
    text:
      v: If yes, is it difficult to control?
    type:
      v: boolean
    enable when:
      question:
        v: depression
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
item:
  link id:
    v: asthma
  text:
    v: Asthma/COPD
  type:
    v: boolean
item:
  link id:
    v: neuro
  text:
    v: Neuromuscular disease
  type:
    v: boolean
item:
  link id:
    v: epilepsy
  text:
    v: Epilepsy
  type:
    v: boolean
  item:
    link id:
      v: neurodisease
    text:
      v: If yes, is it difficult to control?
    type:
      v: string
    enable when:
      question:
        v: epilepsy
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any

link id:
  v: lifestyle
text:
  v: Lifestyle
type:
  v: group
item:
  link id:
    v: breath
  text:
    v: Do you get short of breath during your daily activities?
  type:
    v: boolean
item:
  link id:
    v: occupation
  text:
    v: What is your Occupation?
  type:
    v: string
item:
  link id:
    v: job-risk
  text:
    v: Has your job been at risk due to sleepiness or loss or concentration?
  type:
    v: boolean
item:
  link id:
    v: doze-driving
  text:
    v: Do you have a vehicle licence?
  type:
    v: boolean
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: licenseclass
    text:
      v: What is your vehicle licence class?
    type:
      v: choice
    enable when:
      question:
        v: doze-driving
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: licenseendorsement
    text:
      v: What is your vehicle licence endorsement?
    type:
      v: choice
    enable when:
      question:
        v: doze-driving
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: radio-button
display:
  v: Radio Button

v: Class 1 (motorcar)

v: Class 2

v: Class 3

v: Class 4

v: Class 5

v: Class 6 (Motorcycle)

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: radio-button
display:
  v: Radio Button

v: P

v: V

v: D

v: F

v: R

v: T

v: W

v: I

v: O

link id:
  v: sleep-pattern
text:
  v: Restless Legs
type:
  v: group
item:
  link id:
    v: sleep-time
  text:
    v: 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
  type:
    v: boolean
  item:
    link id:
      v: sleeptime
    text:
      v: If yes, please describe your symptoms:
    type:
      v: text
    enable when:
      question:
        v: sleep-time
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any

link id:
  v: sleephours
text:
  v: Hours of Sleep
type:
  v: group
item:
  link id:
    v: wake-time
  text:
    v: What time do you go to sleep at night?
  type:
    v: time
item:
  link id:
    v: shift
  text:
    v: What time do you get up in the morning?
  type:
    v: time
item:
  link id:
    v: shiftwork
  text:
    v: Do you do shift work?
  type:
    v: boolean
item:
  link id:
    v: usualhourswork
  text:
    v: Please describe your usual hours of work
  type:
    v: text

link id:
  v: medications
text:
  v: Difficulty Sleeping
type:
  v: string
repeats:
  v: true
item:
  link id:
    v: takelongtosleep
  text:
    v: How long does it take you to get to sleep?
  type:
    v: string
item:
  link id:
    v: wakeupatnight
  text:
    v: How many times do you usually wake up during the night?
  type:
    v: string
item:
  link id:
    v: backtosleep
  text:
    v: When you wake up, how long does it usually take you to get back to sleep?
  type:
    v: string
item:
  link id:
    v: disturbsyoursleep
  text:
    v: Do you have pain that disturbs your sleep?
  type:
    v: string

link id:
  v: othersymptoms
text:
  v: Other Symptoms
type:
  v: string
item:
  link id:
    v: hallucinations01
  text:
    v: Do you have hallucinations (you see, feel or hear things that aren’t there) while falling asleep or waking up?
  type:
    v: boolean
  item:
    link id:
      v: hallucinations02
    text:
      v: If yes, please describe your symptoms:
    type:
      v: text
    enable when:
      question:
        v: hallucinations01
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
item:
  link id:
    v: cannotmove
  text:
    v: Do you ever feel you can’t move or talk at all for 1 to 2 minutes after you wake up?
  type:
    v: boolean
item:
  link id:
    v: laughter01
  text:
    v: Do you have sudden bouts of muscle weakness brought on by laughter or emotion?
  type:
    v: boolean
  item:
    link id:
      v: laughter02
    text:
      v: If yes, please describe your symptoms:
    type:
      v: string
    enable when:
      question:
        v: laughter01
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
item:
  link id:
    v: sleepdifficulty01
  text:
    v: Do you have any other difficulties with sleep, like nightmares, acting out dreams, sleepwalking?
  type:
    v: boolean
  item:
    link id:
      v: sleepdifficulty02
    text:
      v: If yes, please describe your symptoms:
    type:
      v: text
    enable when:
      question:
        v: sleepdifficulty01
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any