Adult Sleep Questionnaire

If you answer "True" two or more times, you may have a treatable sleep condition. Call REM Medical today for more information and to schedule an appointment with one of our physicians: 480-991-0480

ADULTS	TRUE	FALSE
I feel sleepy during the day, even when I get a good night's sleep.
I get very irritable when I can't sleep.
I often wake up at night and have trouble falling back to sleep.
It usually takes me a long time to fall asleep.
I often wake up very early and can't fall back to sleep.
I experience an uncomfortable/restless sensation in my legs at night.
My legs often move or jerk during the night.
I sometimes wake up gasping for breath.
My bed partner says my snoring keeps him/her from sleeping.
I've fallen asleep driving.

SOURCE: AASM