This simple quiz is designed to alert you to any problems resulting from poor quality sleep. Select the appropriate response related to symptoms experienced in the last year.
| 1. |
I have trouble falling asleep.
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| 2. |
Thoughts race through my mind and this prevents me from sleeping.
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| 3. |
I feel afraid to go to sleep.
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| 4. |
I wake up during the night and can't go back to sleep.
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| 5. |
I worry about things and have trouble relaxing.
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| 6. |
I wake up earlier in the morning than I would like to.
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| 7. |
I lie awake for half an hour or more before I fall asleep.
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| 8. |
I feel sad and depressed.
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| 9. |
I've been told that I snore.
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| 10. |
I've been told that I stop breathing while I sleep, although I don't remember this when I wake.
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| 11. |
I have high blood pressure.
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| 12. |
My friends and family say they have noticed changes in my personality.
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| 13. |
I am gaining weight.
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| 14. |
I sweat during the night.
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| 15. |
I have noticed my heart pounding or beating irregularly during the night.
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| 16. |
I get morning headaches.
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| 17. |
I am overweight.
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| 18. |
I seem to be losing my sex drive.
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| 19. |
I feel sleepy during the day even though I slept through the night.
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| 20. |
I have trouble concentrating.
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| 21. |
When I am angry or surprised, I feel weak or even like I'm going limp.
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| 22. |
I feel like I go around in a daze.
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| 23. |
I experience vivid dreams several times per week.
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| 24. |
When laughing or crying, I feel weak or even like I'm going limp.
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| 25. |
I have vivid dreams soon after falling asleep.
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| 26. |
I have felt unable to move when I wake up.
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| 27. |
I wake up with heartburn.
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| 28. |
I have chronic cough.
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| 29. |
I use antacids (Rolaids, Tums, Alka-Seltzer, etc) almost every week for stomach trouble.
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| 30. |
I have morning hoarseness.
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| 31. |
I wake up at night coughing or wheezing.
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| 32. |
I have frequent sore throats.
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| 33. |
During the night, I suddenly wake up gasping for breath.
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| 34. |
Other than when exercising, I still experience muscle tension in my legs.
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| 35. |
I have noticed (or others have commented) that parts of my body jerk.
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| 36. |
I have been told that I kick at night.
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| 37. |
I experience aching or crawling sensations in my legs when sitting or before going to sleep.
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| 38. |
Sometimes I can't keep my legs still at night; I just have to move them.
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| Instruction |
QUESTIONS 1-8
If you marked three or more as true, you show symptoms of INSOMNIA, a persistent inability to fall asleep or stay asleep.
QUESTIONS 9-20
If you marked three or more as true, you show symptoms of SLEEP APNEA, a life-threatening disorder which causes you to stop breathing repeatedly, often several hundred times per night during your sleep.
QUESTIONS 19-26
If you marked three or more as true, you show symptoms of NARCOLEPSY, a disorder of dream sleeping. It is a hereditary sleep disorder associated with vivid, frequent dreams and sleepiness.
QUESTIONS 27-33
If you marked three or more as true, you show symptoms of GASTROESOPHAGEAL REFLUX, a disorder caused when acid from the stomach backs up into the esophagus during the night.
QUESTIONS 34-38
If you marked three or more as true, you show symptoms of NOCTURNAL MYOCLUNUS OR RESTLESS LET SYNDROME, a disorder characterized by pain or crawling sensations in the legs. |
