Be a Volunteer

Additional Information

1. Do you smoke?
YesNo

2. Have you ever been diagnosed with any of the following health issues?
High Blood PressureDiabetesPulmonary DiseasePsychiatric Disorders (anxiety, depression, schizophrenia, etc.)Dyslipidemia (high cholesterol levels)Thyroid IssuesI don't have any health problems

3. Do you take any medication?
YesNo

4. Do you have any sleep complaints?
Snoring?Apnea (respiratory arrests while sleeping)Insomnia (difficulty falling or staying asleep)Sleepwalking (getting up, sitting up or walking while sleeping)Bruxism (biting, grinding or clenching your teeth)Daytime sleepinessFatigue or Physical WearinessI have no sleep complaints

5. Have you ever been diagnosed with a sleep disorder?
YesNo

6. Do you take any medication or undergo any treatment for the above sleep disorder?
YesNo

7. Do you authorize us to contact you or use data from your exam and questionnaires, as long as your anonymity is guaranteed in this study?
YesNo

I declare that I have read and accept the privacy terms of Instituto do Sono.