Could you have a sleep disorder?

Page 1 Questions

1. Are you sleepy during the day, even after your usual number of hours of sleep? Required Question

	Yes
	No

2. Has anyone complained of your loud snoring? Required Question

	Yes
	No

3. Have you had a significant weight gain since age 18? Required Question

	Yes
	No

4. Does your bed partner notice pauses in your breathing as you sleep? Required Question

	Yes
	No

5. Have you ever had broken bones in the nose or mouth area? Required Question

	Yes
	No

6. Have your health care providers described your tonsils as being enlarged? Required Question

	Yes
	No

7. Are you aware of any throat or airway difficulties due to injury or disease? Required Question

	Yes
	No

8. Are you aware of having thyroid disease? Required Question

	Yes
	No

9. Has your ability to concentrate decreased? Required Question

	Yes
	No

10. Do you consistently have headaches upon awakening in the morning? Required Question

	Yes
	No

11. Have people around you noticed that you are easily irritated lately? Required Question

	Yes
	No

12. Are you currently taking any medication for high blood pressure? Required Question

	Yes
	No

13. Does your bed partner complain that you seem restless while you sleep? Required Question

	Yes
	No

14. Is your restlessness confined to your legs? Required Question

	Yes
	No

15. As an adult, have you experienced any sleep walking, sleep talking or other "sleep behavior?" Required Question

	Yes
	No

16. Do you awaken often during the night? Required Question

	Yes
	No

17. Does it usually take you longer than 20 minutes to fall asleep? Required Question

	Yes
	No

18. Do you often awaken at a different time every morning? Required Question

	Yes
	No

19. Have you been experiencing spells of weakness or irresistible sleepiness during the day? Required Question

	Yes
	No

50%

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