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Stop Being Sleepy and Start Living
Sleep disorders are different for different people.
Simply check the numbers that apply to you.

1. I have been told that I snore

2. I sometimes suffer from daytime sleepiness

3. If I didn't have coffee, I would doze off after breakfast or at church

4. I have been told that I hold my breath or stop breathing in my sleep

5. I have high blood pressure

6. I toss and turn a lot in my sleep

7. I kick my bed partner at night

8. I often feel my legs have a creepy, crawling and gnawing feeling

9. I get up and visit the bathroom more than once a night

10. I often feel sleepy and struggle to stay awake, especially during afternoon meetings

11. I frequently fall asleep watching TV

12. I often feel sleepy at a stoplight or stop sign

13. I have actually fallen asleep while driving

14. I wish I had more energy and less fatigue - I feel tired all the time

15. My neck measures over 17 inches (male)/16 inches (female)

16. I am more than 15 pounds overweight

17. I seem to be losing my sex drive or my ability to perform in bed

18. I sometimes get heartburn in the middle of the night

19. I frequently wake up with a bad taste in my mouth or with a dry mouth and throat

20. When I can not wake up from a nightmare, I feel paralyzed and panic

21. My dreams seem to last a long time and are very intense and vivid

22. I often get morning headaches

23. I suddenly wake up gasping for breath

24. I sometimes wake up with a pounding or irregular heartbeat

25. My friends and family say I'm more grumpy and irritable than I used to be

26. I frequently feel depressed

27. I feel as if I'm getting too old too fast

28. I don't feel rested or refreshed, even after eight or ten hours of sleep

29. I have short-term memory problems and/or difficulty concentrating

30. I sometimes perspire a lot, expecially at night

31. I have had a stroke or a heart attack in the past ten years

Please answer to the best of you ability based on the last two weeks:

32. Feeling sad or empty?

33. Loss of interest or pleasure?

34. Weight gain or loss?

35. Restlessness or being slowed down?

36. Fatigue or loss of energy?

37. Feelings of worthlessness or indecisiveness?

38. Thoughts of death?

39. Restlessness or feeling keyed up or on edge?

40. Difficulty concentrating or mind going blank?

41. Irritability?

42. Muscle tension?