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Sleep Assessment

Sleep Symptom Assessment

This sleep symptom assessment questionnaire is a simple, evidence based screening tool that helps identify people who may be at risk for common sleep disorders such as sleep apnea, insomnia, daytime fatigue, or excessive sleepiness.

By asking targeted questions about sleep habits, snoring, breathing during sleep, and daytime functioning, it helps determine whether further evaluation is needed. This questionnaire does not provide a diagnosis, but allows our sleep specialists to recommend the most appropriate next steps.

This approach ensures testing and treatment are thoughtful, efficient, and tailored to your individual symptoms, which may include lifestyle guidance, sleep testing, or therapy support.

If you believe you may be experiencing a sleep disorder, please schedule an appointment.

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1. I’ve been told that I snore loudly

 
 

2. I’ve been told that I stop breathing while I sleep, although I don’t remember this when I wake up

 
 

3. I have high blood pressure

 
 

4. My friends and family say they have noticed changes in my personality

 
 

5. I am obese, overweight or seem to be gaining weight

 
 

6. I suddenly wake up gasping for breath during the night

 
 

7. Despite sleeping all night, I don’t feel refreshed when I wake up.

 
 

8. I wake up with a headache in the morning

 
 

9. I seem to be losing my sex drive

 
 

10. I feel sleepy during the day even though I have slept through the night

 
 

11. I wake up during the night and can’t go back to sleep, or awaken earlier than I would like

 
 

12. I have difficulty falling asleep or feel afraid to go to sleep

 
 

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