Sleep Survey
Take a moment and read the following. Is this you?
-
I have been told that I gasp, snort or stop breathing at night Yes No
-
My neck size is 17 inches or more for men, over 16 inches for women Yes No
-
I have night time reflux ( a bad taste in my mouth during the night, mild regurgitation) Yes No
-
I can fall asleep easily during the day, even after 6 or more hours of sleep Yes No
-
I have been told I snore loudly Yes No
-
I have high blood pressure Yes No
-
I have been told I snore less sleeping on my side Yes No
-
I have excessive daytime sleepiness and/or daytime fatigue even though I have slept Yes No
-
I have been awakened with gasping and choking sensation. Yes No
-
I have been depressed and have been told that my personality has changed Yes No
-
I am overweight Yes No
-
I wake up with morning headaches, and I do not grind my teeth at night. Yes No
If you answered yes to the majority of these questions, contact your physician and bring a copy of this survey with you. Sleep apnea or sleep obstruction can prevent that deep, resting sleep that is needed to refresh your energy for the day. Sleep studies are available through St. Thomas More Hospital.
Click here for a printable sleep survey











