Sleep Questionnaire

Quick and Simple Screening Test

MARITIME SLEEP CLINIC AND RESPIRATORY SERVICES - LA CLINIQUE DU SOMMEIL DES MARITIMES ET SERVICES RESPIRATOIRES

Do I need a sleep study?

Chances are, if you are visiting our website, you could be a candidate for a sleep study. More definitively, you can take a quick and simple screening test that will let you know if you should pursue testing or not. In order to determine whether you may be affected by some type of sleep disorder breathing, we kindly ask you to answer the following questionnaire.

    Do you snore loudly (louder than normal talking or loud enough to be heard through closed doors)?

    YesNo

    Do you often feel tired, fatigued or sleepy during the day?

    YesNo

    Has anyone observed you stopping breathing during your sleep?

    YesNo

    Do you have or are you being treated for high blood pressure?

    YesNo

    Your Name (required)

    Your Email (required)

    Closest Location