Take the TMD/Pain Quiz Patient Success Stories Pediatric Sleep Quiz I. While Sleeping, does your child...1. Snore more than half the time?*YesNo2. Always Snore?*YesNo3. Snore Loudly*YesNo4. Have "heavy" or loud breathing?*YesNo5. Have trouble breathing or struggle to breathe?*YesNo6. Have you ever seen your child stop breathing during the night?*YesNoII. Does your child...1. Tend to breathe through their mouth during the day?*YesNo2. Have a dry mouth on waking in the morning?*YesNo3. Occasionally wet the bed?*YesNo4. Wake up feeling unrefreshed in the morning?*YesNo5. Have a problem with sleepiness during the day?*YesNo6. Have a teacher or other supervisor who commented that your child sleeps during the day?*YesNo 7. Find it hard to wake up in the morning?*YesNo8. Wake up with headaches in the morning?*YesNoIII. Did your child stop growing at a normal rate at any time since birth?*YesNoIV. Is your child overweight?*YesNoSection BreakV. This child often...1. Does not seem to listen when spoken to directly.*YesNo2. Has difficulty organizing tasks and activities.*YesNo3. Is easily distracted by etraneous stimuli.*YesNo4. Fidgets with hands or feet or squirms in seat.*YesNo5. Is 'on the go' or often acts as if 'driven by a motor.'*YesNo6. Interrupts or intrudes on others (e.g. butts into conversations or games).*YesNoIF YOU ANSWERED YES TO ANY OF THE QUESTIONS ABOVE, YOUR CHILD MAY BE AT RISK OF SLEEP APNEA Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.Name* Name Phone*Email* Message*EmailThis field is for validation purposes and should be left unchanged. SPEAK TO ONE OF OUR FRIENDLY TEAM MEMBERS TODAY!(972) 538-3777 Request Appointment Online