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Sleep Health Online Questionnaire

One in three Americans suffer from a sleep disorder, negatively impacting their daily life activities, overall health and relationships with family, friends and co-workers.

Complete the short survey below to better understand and start getting a better night’s sleep.

Do you fall asleep unintentionally during the day?

Do you wake up with morning headaches?

Do you find it hard to concentrate or stay awake while watching TV or reading a book?

Have you fallen asleep while driving?

Do you ever wake up choking, gasping for air, or have a skipping or racing heartbeat during the night?

Has a bed partner expressed concern about your snoring, gasping or breath-holding?

Do your legs jerk before or during sleep?

Do you have a crawling or creeping feeling in your legs that keeps you from falling asleep?

Do you have difficulty falling asleep or maintaining sleep throughout the night?

Do you have high blood pressure?

Do you have a primary care doctor?

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