Sleep Survey

* indicates required field

How many hours of sleep are you now getting in a typical night?
How many minutes does it take you to fall asleep once you are in bed? (60 minutes = 1 hr)
Check off the following behaviors occurring during your sleep that either you or someone else has observed in the past year.
If you chose "Other" in "Sleep Behavior" please provide a description.
Do you feel very drowsy or sleepy at any point during the day?
Do you have strange hallucination-like dreams while napping?
Do you ever have “sleep attacks” during the day? (periods when you cannot prevent Yourself from falling asleep)
Do you ever have “Cataplectic Attacks” (episodes when you suddenly feel weak in the legs and collapse?
Have you ever had a NEAR ACCIDENT or ACCIDENT due to excessive drowsiness?
Answer Proves Your Human