For VA Providers
Patient Sleep Questionnaire
Tick the box if you answer Yes to any of these questions
Do you feel tired or fatigued during the day?
Do you doze off during the day while watching TV, sitting down in the afternoon, or stopped in traffic? (at least once a month)?
Do you Snore? (lauder than your breathing, at least once a month)?
Has anyone told you that you stop breathing while you sleep?
Have you ever woken up gasping or choking?
Do you have morning headaches (more than once a month)?
Do you have high blood pressure or Atrial Fibrilation?
If you have checked any of these you are at risk for sleep apnea and should take action to improve your sleep
One of our representatives will reach out to you via email about next steps.