Survey on Rosacea and Sleep

Please fill out the following survey about rosacea and sleep. Results will be reported in the National Rosacea Society's newsletter and on rosacea.org.

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* 1. Does rosacea negatively affect your ability to get quality sleep?

Yes

Sometimes

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* 2. Conversely, does the ability to get a good night's sleep improve your rosacea?

Yes

Sometimes

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* 3. Do you have more trouble sleeping when experiencing a flare-up?

Yes

Sometimes

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* 4. Do you suffer from insomnia?

Yes

I don't know

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* 5. Do you suffer from sleep apnea or another obstructive breathing issue?

Yes

Sometimes

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* 6. Has medical therapy for rosacea helped improve your ability to sleep?

Yes

Somewhat

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* 7. Are you...

Male

Female

Non-binary/other

Prefer not to answer

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* 8. Are you...

Under 30

30-39

40-49

50-59

60-69

70 or older

Prefer not to answer

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* 9. Comment:

Question Title

* 10. Would you like to receive the latest information on rosacea? Join the NRS mailing list by providing your contact information below.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address