Sleep plays such an important part in the management of Parkinson's. Certain factors such as diet and exercise impact the quality of sleep. Parkinson's medication is much more effective after a good night sleep.

The following questionnaire has been designed to help you identify your sleep patterns. Once completed, you can print your completed survey (use the menu on the left hand side) which you can then take to your next appointment with your healthcare professional if you felt it was relevant.

* 1. How long have you been diagnosed Parkinson's?

* 2. Are you Male or Female?

* 3. Have you ever discussed sleep problems with a healthcare professional (GP, nurse, neurologist, physiotherapist etc)

* 5. Some people experience sleepiness in the daytime. Choose one of the following statements to rate your degree of sleepiness during the day (although we do realise this changes on a day to day basis)

* 6. Please tick any of the statements that apply to you about daytime sleepiness

* 7. If you experience daytime sleepiness, what time are you most affected?

* 8. Please choose any of the following which apply to you while asleep. If you have a partner it may be helpful to discuss this.

* 9. Please mark any of the statements you feel are relevant to you when in bed asleep or awake.

* 10. On average, what time do you go to bed?

* 11. On average, what time do you wake in the morning?

* 16. When I wake up I feel

* 17. At what time do you eat your main meal?

* 19. What medications do you take in the evening and at what time?

Report a problem