Sleep Disorder Screening Questionnaire

This is a screening questionnaire to explore how common sleeping disorders are in MSers.
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    Scoring system

    Questions 1-12: If you marked three or more boxes, you show symptoms of Sleep Apnea – a potentially serious disorder which causes you to stop breathing repeatedly, often hundreds of times in the night during your sleep. Questions 13-19: If you marked three or more boxes, you show symptoms of Insomnia – a persistent inability to fall asleep or stay asleep. Questions 20-27: If you marked three or more boxes, you show symptoms of Narcolepsy – a life long disorder characterized by uncontrollable sleep attacks during the day. Questions 28-34: If you marked three or more boxes, you show symptoms of Periodic Limb Movement Disorder uncontrollable leg or arm jerks during sleep or Restless Leg Syndrome – uncomfortable feelings in the legs at night. This is an anonymous survey; you will therefore need to PRINT the survey after completing it, prior to submitting it, if you want to use it to assess yourself for a sleep disorder.

    Demographics

    The demographics will help when analyzing the data above.
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    Disclaimer

    No personal identifiers, including your computer's IP address, will be collected as part of this survey. Please note that by completing this survey you are consenting to the data you provide being analysed by Prof. Giovannoni and his collaborators. Results of this survey will be presented on this blog and may be submitted for publication.