Morning Questionnaire

Full Name

Date of birth:

Your Email:

What clinic did you attend for your sleep study?

1. Compared to your usual sleep, how well did you sleep last night?

2. What time did you go to bed (Lights out time)?:

3. What time did you rise from bed?:

4. How long do you think it took you to fall asleep?:

5. How long do you feel you slept?:

6. Was alcohol consumed last night?
YESNO

How many standard drinks do you consume?:

7. Were sedatives taken last night?
YESNO

What sedatives were taken?:

8. Did you wake up during the night?: YESNO

9. Did you notice any wires come off?: YESNO