PATIENT INFORMATION
Snoring - Has anyone ever mentioned you snore loudly?
Do you feel refreshed when you wake after 7 hours sleep?
For each situation listed below, circle a number from 0 to 3 that best reflects how likely you are to fall asleep. Be as realistic as you can.
0 – No chance of falling asleep 1 – Slight chance of falling asleep 2 –Good Chance of falling asleep 3 – High chance of falling asleep
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