Male Questionnaire
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SYMPTOMS: SLEEP: OTHER PROBLEMS

If you sleep with a partner, they may be able to help you answer some of these questions.

Q544

Do you ever wake up during the night gasping for air, or with a choking sensation?
  • No / don't know
  • Occasionally - less than once per month
  • Often - at least once per month

Q545

How often do you wake up with a dry mouth? Do not include dry mouth that is caused by sleeping with your mouth open for known physical reasons such as nasal obstruction, a skeletal defect, or abnormally large tonsils.
  • Never / almost never / don't know
  • I sleep open-mouthed for a known physical reason
  • Occasionally - once a month or less
  • Regularly - a few times a month
  • Usually or always

Q546

How often do you wake up with dry eyes? Do not include dry eyes that are caused by sleeping with your eyes open or partially open (a condition known as Nocturnal Lagophthalmos).
  • Never / almost never / don't know
  • I sleep with my eyes (partially) open
  • Occasionally - once a month or less
  • Regularly - a few times a month
  • Usually or always

Q547

Do you ever wake up choking on a mouthful of stomach acid that is burning your mouth and throat?
  • No / don't know
  • Very rarely
  • Yes, at least once a year
  • Yes, at least once a month
  • Yes, at least once a week

Q548

Do you suffer from clenching or grinding of teeth while you sleep (Bruxism)? If you sleep with a partner, it may be worth asking them.
  • No / don't know
  • Mildly - it was mentioned but I feel/see no signs
  • Moderately - I grind my teeth but no damage yet
  • Seriously - some damage to teeth
  • Severely - extensive damage to teeth

Q549

Do you experience restless sleep, tossing and turning during the night?
  • No / don't know
  • A little
  • Very much so

Q550

Do you have Insomnia (difficulty falling asleep)?
  • No / don't know
  • Occasionally
  • Often
  • Very often / always

Q551

Do you fall asleep only to wake up after a few hours and have trouble falling back to sleep?
  • No / don't know
  • Occasionally
  • Often
  • Very often / always

Q552

Do you have Sleep Apnea (periods of at least 10 seconds where you stop breathing while asleep)? If you sleep with a partner, you may want to ask them.
  • Don't know
  • No, definitely not
  • In the past only
  • Minor problem
  • Major problem

Q553

Do you snore? If unsure, try to ask someone who has been with you while you sleep.
  • No / don't know
  • Mildly
  • Quite a lot
  • Very much - people complain

Q554

Have you been diagnosed with a sleep disorder such as Hypersomnolence or Narcolepsy?
  • Don't know
  • No
  • Similar sleep disorder / doctors uncertain
  • Hypersomnolence
  • Narcolepsy

Q555

Have you experienced Sleep Paralysis? When this happens, you are awake and aware but temporarily unable to move or talk.
  • Don't know
  • No, never
  • Yes, episode(s) in the past but not currently
  • Occasionally / a few episodes per year on average
  • Frequently / several episodes per month on average

Q556

Have you experienced Night Terrors? Not the same as nightmares, they involve persistent fear, screaming, sweating, racing pulse, rapid breathing, and confusion lasting up to 30 minutes. You cannot be woken up and usually have no memory of a bad dream.
  • Don't know
  • No, never
  • Yes, episode(s) in the past but not currently
  • Occasionally / a few episodes per year on average
  • Frequently / several episodes per month on average

Q557

Have you experienced Sleepwalking? These are episodes where you perform activities in your sleep (not necessarily just walking) and have no knowledge at the time that you are doing them.
  • Don't know
  • No, never
  • Yes, episode(s) in the past but not currently
  • Occasionally / a few episodes per year on average
  • Frequently / several episodes per month on average