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Patient Information

Sleep History

* Do you have difficulty falling asleep at the beginning of the night?
* Do you have racing thoughts going through your mind while trying to fall asleep or after waking up in the middle of the night?
* Do you have difficulty staying asleep throughout the night?
* Do you take medications to fall or stay asleep?
* Do you awaken at night to use the bathroom?
* Do you need an alarm clock?
* Do you feel refreshed when you awaken to start your day?
* Do you experience an unsettled, restless sensation in your legs while laying in bed?
* Have you been told that you make kicking and twitching movements while asleep?
* Do you snore at night?
* Have others told you that you have pauses in breathing or that you make frequent gasping sound when sleeping?
* Does your bed partner frequently sleep in another room because of how you sleep?