OCA Home SECURE LOGIN NOTICE OF PRIVACY PRACTICES CONTACT US ABOUT OCA
Search:
   






OCA Heart Home





back Go Back
How well do you sleep? Sleep Survey

How Well Do You Sleep?  A Self Test.

This survey is not intended as medical advice and should not be used for diagnosis or treatment of sleep disorders.

 

Sleep Apnea

1. I've been told that I snore.

2. I've been told that I stop breathing when I sleep, although I may not remember this when I wake up.

3. I feel sleepy during the day even though I sleep through the night.

4. I have high blood pressure.

5. I've been told that I am a restless sleeper - that I toss and turn a lot at night.

6. I sweat excessively during the night.

7. I frequently awaken with headaches.

8. I am overweight and/or am gaining weight.

9. I seem to be losing my sex drive.



Insomnia

10. I have real difficulty falling asleep.

11. Thoughts race through my mind and this prevents me from sleeping.

12. I wake up during the night and can't go back to sleep.

13. I wake up earlier in the morning than I would like to and can't go back to sleep.

14. I'll lie awake for half an hour or more before I fall asleep.


Narcolepsy

15. I had trouble concentrating when I was in school.

16. When I am angry, or surprised, or laugh, I feel like I am going limp.

17. I have fallen asleep while driving.

18. I feel like I go around in a daze.

19. I experience vivid dreamlike scenes upon falling asleep or wakening.

20. I have fallen asleep while laughing or crying.

21. I have trouble at work because of sleepiness.

22. I have vivid nightmares soon after falling asleep.

23. Sometimes, no matter how hard I try to stay awake, I fall asleep anyway.

24. I feel like I have to cram a full day into every hour to get anything done.

25. Sometimes I feel unable to move when I'm waking up or falling asleep.


Periodic Limb Movement Disorder & Restless Legs Syndrome

26. I experience muscle tension in my legs even when I am otherwise relaxed.

27. I have noticed, or others have commented, that parts of my body jerk.

28. I have been told that I kick at night.

29. I experience aching or crawling sensations in my legs.

30. I experience leg pain during the night.

31. Sometimes I can't keep my legs still at night - I just have to move them.

32. Even though I sleep through the night I feel sleepy during the day.


Gastroesophageal Reflux

33. I wake up with heartburn.

34. I have a chronic cough

35. I have to use antacids (Rolaids, Tums, Alka-Seltzer, etc.) almost every week for stomach trouble.

36. I am hoarse in the morning.

37. I wake up at night coughing and wheezing.

38. I have frequent sore throats.

39. During the night I suddenly wake up gasping for breath.


Score

Questions 1 through 9
You marked boxes.

If you marked three or more boxes, you show symptoms of Sleep Apnea, a life threatening disorder which causes you to stop breathing, in many cases, several hundred times per night.


Questions 10 through 14
You marked boxes.

If you marked one or more boxes, you show symptoms of insomnia, a persistent inability to fall asleep or stay asleep.


Questions 15 through 25
You marked boxes.

If you marked three or more boxes, you show symptoms of Narcolepsy, a lifelong disorder, characterized by uncontrollable attacks of sleepiness during the day.


Questions 26 through 32
You marked boxes.

If you marked two or more boxes, you show symptoms of Periodic Limb Movement Disorder (PLMD) and/or Restless Leg Syndrome (RLS), two disorders that can result in disturbed sleep. PLMD is characterized by uncontrollable periodic movement during sleep. RLS is characterized by leg discomfort requiring movement to ease the discomfort.


Questions 33 through 39
You marked boxes.

If you marked three or more boxes, you show symptoms of Gastoesophageal Reflux, a disorder caused when acid from the stomach "backs up" into the esophagus during the night. This condition can lead to damage to the esophagus and pneumonia.

 

 


If you are concerned about the results of your Sleep Survey, please contact your physician or The Sleep Clinic at 405.767.6970 to discuss these concerns.



 
     
Bottom Left Corner   Bottom Right Corner