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State of California - Health and Human Services Agency ADMINISTRATIVE USE ONLY Testing Referral (check one): LEO GROUP SELF ADMINISTERED QUESTIONNAIRE (GSAQ) Referrals: (1) Tested at Encounter (1).

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Global Sleep Assessment Questionnaire (GSAQ). The 11 items cover mood, life activities and medical issues as they relate to sleep, along with symptoms associated with insomnia, obstructive sleep apnea, restless legs syndrome/periodic limb movement, and parasomnias.

1) What time do you start getting ready for bed? 2) What time do you usually go to bed? 3) What time do you usually go to sleep? 4) What time do you usually wake up?

The ISI is a seven-item self-report questionnaire. The seven answers are added up to get a total score. The scale assesses sleep-onset and sleep maintenance difficulties, associated distress, and interference with daily functioning. Each item is rated on a 0-4 scale.

How many hours a night do you sleep? This question is important for the nurse to assess the patient's waking and sleeping times.

It is a 12-point scoring system ranging from 0 to 3 for each question. Scores are rated as normal (0–2), mild (3– 5), moderate (6–8), and severe (9–12). 16 Statistical analysis Patients were classified into two groups GSAQ positive and GSAQ negative.

1) What time do you start getting ready for bed? 2) What time do you usually go to bed? 3) What time do you usually go to sleep? 4) What time do you usually wake up?

Do I have Sleep Apnea? – Screening Questionnaire S (snore) Do you snore? T (tired) Do you feel fatigued during the day? Do you wake up feeling like you haven't slept? O (obstruction) Have you been told you stop breathing at night? ... P (pressure) Do you have high blood pressure or are on BP medication?

Begin a focused assessment on a patient's sleep patterns by asking an open-ended question such as, “Do you feel rested upon awakening?” From there, five key sleep characteristics should be assessed: sleep duration, sleep quality, sleep timing, daytime alertness, and the presence of a sleep disorder.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232