|
Sleep History
|
|
|
Difficulty falling asleep?
|
Comments
|
|
Difficulty staying asleep?
|
Comments
|
|
Problems waking up early?
|
Comments
|
|
Does you sleep problem INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability
|
|
|
Berlin Sleep Questionnaire
|
|
|
Sleep Category 1
|
|
|
1. Do you snore?
|
|
|
2. If ‘yes’: Your snoring is:
|
|
|
3. How often do you snore?
|
|
|
4. bothered other people?
|
|
|
5. stop breathing during sleep
|
|
|
Sleep Category 2
|
|
|
6. How often feel tired waking up?
|
|
|
7. Tired during the day?
|
|
|
1. Fall asleep while driving?
|
|
|
Sleep Category 3
|
|
|
Any of the following conditions?
• • •
|
|
|
Hours of sleep nightly
|
|
