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How well did you sleep last night?

a. If "Yes," on how many days during the last two weeks did you take this medicine?

Do you usually have a runny or stuffy nose?

Participant had attack of asthma in last 12 months?

Doctor of Medicine (MD) said participant had coronary angioplasty?

Doctor of Medicine (MD) said participant had coronary artery bypass graft (CABG)?

Do you cough on most days for as much as 3 months of the year?

Doctor of Medicine (MD) said participant had angina?

Doctor of Medicine (MD) said participant had pacemaker?

Doctor of Medicine (MD) said participant had sleep apnea?

Doctor of Medicine (MD) said participant had other heart/cardiac surgery?

Doctor of Medicine (MD) said participant had chronic obstructive pulmonary disease (COPD)?

Do you bring up phlegm from your chest on most days for as much as three months of the year?

a. If both day and night, do they get worse at night?

Doctor of Medicine (MD) said participant had emphysema?

Doctor of Medicine (MD) said participant had chronic bronchitis?

C. Restless legs 8. In the past year, while SITTING OR LYING DOWN, have you had any of the following symptoms? b. Unpleasant or uncomfortable feelings in your legs

C. Restless legs 8. In the past year, while SITTING OR LYING DOWN, have you had any of the following symptoms? a. An urge to move your legs

C. Restless legs [Questions #11-15 refer to all symptoms you checked as present in item #8.11.] These symptoms are most likely to occur when you are (check the one best answer):

C. Restless legs [Questions #11-15 refer to all symptoms you checked as present in item #8.11.] 12. Are they worse when you are sitting or lying down than when you are moving around or walking?

C. Restless legs [Questions #9-10 are about your MOST FREQUENT symptom you checked as yes in item #8.] 9. How often do you get this symptom? (check the one best answer)

C. Restless legs [Questions #9-10 are about your MOST FREQUENT symptom you checked as yes in item #8.] 10. How bothersome or troublesome is this symptom? (answer based on most frequent symptom) Does it bother you: (check one)

C. Restless legs [Questions #11-15 refer to all symptoms you checked as present in item #8.11.] 13. Do the symptoms improve if you get up and start walking?

C. Restless legs [Questions #11-15 refer to all symptoms you checked as present in item #8.11.] 15. How old were you when you first noticed these symptoms? (write in "D" if Don't know) _____ _____ age in years (approximate OK)