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In the past year, how often, on average, have you been awakened with sweats or hot flashes?

In the past year, how often, on average, have you been awakened with pain in your joints, muscles, or back?

Please indicate how often you experience each of the following. (check one box for each in items a through j) h. Nasal stuffiness, obstruction or discharge at night.

In the past year, how often, on average, have you been awakened with the need to go to the bathroom?

In the past year, how often, on average, have you been awakened with heartburn or indigestion?

In the past year, how often, on average, have you been awakened with leg cramps or leg jerks?

Have you ever had surgery as treatment for your snoring?

How loud is your snoring?

Questions 9 through 15 are about snoring and breathing during sleep. To answer these questions, please consider both what others have told you AND what you know about yourself. 14. Are there times when you stop breathing during your sleep?ng

In the past year, how often, on average, have you been awakened with shortness of breath?

For how many years have you been snoring? (number of years, up to 2 digits)

To answer these questions, please consider both what others have told you AND what you know about yourself. 15. How often do you have times when you stop breathing during your sleep?

Is your snoring: (increasing, decreasing, etc) 1=Increasing over time, 2=Decreasing over time, 3=Staying the same, 8=Don't know

How often do you feel excessively (overly) sleepy during the day?

Questions 9 through 15 are about snoring and breathing during sleep. To answer these questions, please consider both what others have told you AND what you know about yourself. 9. Have you ever snored (now or at any time in the past)?

Questions 9 through 15 are about snoring and breathing during sleep. To answer these questions, please consider both what others have told you AND what you know about yourself. 12. Has your snoring been: (check one)

How often do you have times when you stop breathing during your sleep? 1=Rarely-less than 1night/wk, 2=Sometimes-1 or 2nights/wk, 3=Frequently-3 to 5nights/wk, 4=Always or almost always-6 or 7nights/wk, 8=Don't know

Original question: What is chance that you would doze off or fall asleep while driving?

Questions 9 through 15 are about snoring and breathing during sleep. To answer these questions, please consider both what others have told you AND what you know about yourself. 10. How often do you snore now? (check one)

Do you sleep with either a pressure mask (Continuous Positive Airway Pressure (CPAP)) or a mouthpiece as treatment for your sleep apnea?

Questions 9 through 15 are about snoring and breathing during sleep. To answer these questions, please consider both what others have told you AND what you know about yourself. 11. How loud is your snoring? (check one)

How often do you snore? 0=Do not snore any more, 1=Rarely-less than 1 night/wk, 2=Sometimes-1 or 2 nights/wk,3=Frequently-3 to 5nights/wk, 4=Always or almost always-6 or 7nights/wk, 8=Don't know

Original question: What is chance that you would doze off or fall asleep while at the dinner table?

To answer these questions, please consider both what others have told you AND what you know about yourself. 13. Have you ever had somnoplasty, laser treatment, or surgery as treatment for your snoring?

Please indicate how often you experience each of the following. (check one box for each in items a through j) e. Feel excessively (overly) sleepy during the day.