Are you sleepy during the day?
NeverSeldomOftenVery often

Do you ever fall asleep spontaneously during the day?
NeverSeldomOftenVery often

Do you find it difficult to maintain your concentration for a longer period of time?
NeverSeldomOftenVery often

Are you less productive than you are used to?
NeverSeldomOftenVery often

Do you snore or is your partner complaining about you snoring?
NeverSeldomOftenVery often

Has your partner noticed that you stop breathing during your sleep?
NeverSeldomOftenVery often

Do you wake up with headaches in the morning?
NeverSeldomOftenVery often

Do you feel tired and dizzy in the morning?
NeverSeldomOftenVery often

Do you ever fall asleep while watching television, reading, working at the office, driving or talking to others?
NeverSeldomOftenVery often

Do you find it difficult to fall asleep when you go to bed?
NeverSeldomOftenVery often

Do you wake up at night?
NeverSeldomOftenVery often

Do you wake up earlier than you are used to, or does it take longer before you fall asleep again?
NeverSeldomOftenVery often

Are you restless in your sleep, or do you notice that your bed is messy when you wake up?
NeverSeldomOftenVery often

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Would you like to get mmore information about a sleep test that checks your sleep at home?
YesNo