We would like to understand whether your sleep apnea and/or snoring have had an impact on your daily activities, emotions, social interactions, and about symptoms that may have resulted.
PLEASE SCORE THE FOLLOWING QUESTIONS ACCORDING TO THE FOLLOWING:
A very large = 1
A large = 2
A moderate to large = 3
A moderate = 4
A small to moderate = 5
A small = 6
No or none = 7
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| How much (amount) have you had to push yourself to remain alert during a typical day (e.g. work, school, childcare, housework)? |
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| How have (amount of time) you had to use all your energy to accomplish your most important activity (e.g. work, school, childcare, housework)? |
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| How much difficulty (amount) have you had finding the energy to do other activities (e.g. exercise, relaxing)? |
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| How much difficulty (amount) have you had fighting to stay awake? |
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| How much of a problem has it been to be told that your snoring is irritating? |
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| How much of a problem have frequent conflicts or arguments been? |
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| How often (amount of time) have you looked for excuses for being tired? |
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| How often (amount of time) have you not wanted to do things with your family and/or friends? |
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| How often (amount of time) have you felt depressed, down, or hopeless? |
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| How often (amount of time) have you been impatient? |
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| How much of a problem has it been to cope with everyday issues? |
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| How much of a problem have you had with decreased energy? |
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| How much of a problem have you had with fatigue? |
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| How much of a problem have you had waking up feeling unrefreshed? |
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