Sleep Observers Questionnaire
The following questions relate to the behavior that you have observed in the patient while he/she is asleep. Use the following scale to choose the most appropriate number for each situation.
0 = Never
1 = Infrequently (1 night per week)
2 = Frequently (2-3 nights per week)
3 = Most of the time (4 or more nights per week)
|Loud, irritating snoring||______|
|Choking or gasping for air||______|
|Pauses in breathing||______|
|Twitching / kicking of arms or legs||______|
|Snoring requiring separate bedrooms||______|
|Falling asleep inappropriately (i.e. while driving or at meetings)||______|
Total score ______
A score of 5 or greater indicates symptoms which are affecting the health, safety, or quality of life of the observed person.