How Well Are You Really Sleeping?

Please rate each of the following statements based on your experience:

1 = Never | 2 = Rarely | 3 = Sometimes | 4 = Often | 5 = Constantly

Name:^*

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Sleep Quality Assessment

1. 🧠 Morning Headaches^*

Do you wake up feeling like you got into a pillow fight... and lost?

Yes

No

2. 😬 Teeth Grinding (Bruxism)^*

Does your jaw feel like it just bench-pressed 200 pounds overnight?

Yes

No

3. 😝 Bad Taste or Dry Mouth in the Morning^*

Does your mouth taste like you licked a battery... or crossed the Sahara on foot?

Yes

No

4. 🤧 Stuffy Nose or Frequent Sinus Infections^*

Is breathing through your nose in the morning a full-body workout?

Yes

No

5. 🥱 Unrefreshing Sleep^*

Do you wake up wondering, "Did I sleep... or just blink for 8 hours?"

Yes

No

6. 😴 Daytime Sleepiness and Fatigue^*

Are you fighting to stay awake in meetings... or at stoplights?

Yes

No

7. 🚽 Nighttime Bathroom Trips^*

Do you make more nighttime trips to the bathroom than a toddler on a road trip? (Heart racing included.)

Yes

No

8. 💤 Snoring or "Loud Breathing" at Night^*

Has your partner, roommate, or even your dog considered filing a noise complaint?

Yes

No

9. 😖 Throat Pain or Tightness in the Morning^*

Does your throat feel like it spent the night running a marathon without you?

Yes

No

10. ⚖️ Trouble Losing Weight^*

Despite your heroic salad-eating efforts, does the scale refuse to budge?

Yes

No

11. ❤️ High Blood Pressure That’s Hard to Manage^*

Are your numbers high even when you're doing "everything right"?

Yes

No

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