| Name | Label | Folder | |
|---|---|---|---|
|
famhx_0100
Family History of Insomnia
|
Family History of Insomnia
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Insomnia |
Medical History/Family History | |
|
famhx_0200
Family History of Sleep Apnea
|
Family History of Sleep Apnea
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Sleep Apnea |
Medical History/Family History | |
|
famhx_0300
Family History of Narcolepsy
|
Family History of Narcolepsy
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Narcolepsy |
Medical History/Family History | |
|
famhx_0400
Family History of Restless Leg Syndrome
|
Family History of Restless Leg Syndrome
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Restless Leg Syndrome |
Medical History/Family History | |
|
famhx_0500
Family History of Other Sleep Disorder
|
Family History of Other Sleep Disorder
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Other sleep disorder |
Medical History/Family History | |
|
famhx_0600
Family History of Sleepwalking
|
Family History of Sleepwalking
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Sleepwalking |
Medical History/Family History | |
|
famhx_0700
Family History of Fibromyalgia or Chronic Fatigue
|
Family History of Fibromyalgia or Chronic Fatigue
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Fibromyalgia or Chronic Fatigue |
Medical History/Family History | |
|
famhx_0800
Family History of Depression
|
Family History of Depression
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Depression |
Medical History/Family History | |
|
famhx_0900
Family History of Anxiety
|
Family History of Anxiety
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Anxiety |
Medical History/Family History | |
|
famhx_1000
Family History of Other Psychiatric Illness
|
Family History of Other Psychiatric Illness
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Other psychiatric illness |
Medical History/Family History | |
|
famhx_1100
Family History of Psychiatric Treatment
|
Family History of Psychiatric Treatment
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Psychiatric treatment |
Medical History/Family History | |
|
famhx_1200
Family History of Death During Sleep
|
Family History of Death During Sleep
Have any blood relatives in your immediate family (which includes brother/sister, father/mother, son/daughter) had any of the following? Death during sleep |
Medical History/Family History | |
|
famhx_1300
Number of full siblings from the same birth parents
|
Number of full siblings from the same birth parents
How many full siblings do you have (from the same birth parents)? |
Medical History/Family History |