Dose the patient being treated have any of the following conditions?

• Less than 12 years old.

• 65 years old or older.

• Have been unable to sleep properly for over 3 weeks in a row.

• Have a psychiatric condition or are not sleeping due to another health condition.

• After falling asleep, sudden awakenings are frequently occurring (frequent sleep interruptions of an unknown cause).

• Pregnancy.


Yes

No



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