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SomniFix
Mouth Strips

28

One - Time

4 week pack

$23.0 PER 1 MONTH

84

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12 week pack

$68.0 $53.0 PER 3 MONTHS

364

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$293.0 $207.0 PER 12 MONTHS

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28 Strips = 4 Weeks

$23.99


Sleep profile

Are you able to breathe through your nose?

Yes, I am able to breathe through my nose
No, I am unable to breathe through my nose
I am able to breathe through my nose during the day, but I am unable to breathe through nose at night only

How do you describe your sleep?

I sleep the full night
I toss and turn
I can’t stay asleep
I can’t fall asleep at all

Do you experience any of the following when you wake up?

Dry mouth
Sore throat
Nasal congestion

How do you usually sleep?

Sleep on back
Sleep on side
Sleep on stomach
Other

How would you describe your sleeping pattern? Select all that apply

Open mouth snorer
CPAP user
Non-snorer
Oral appliance user

If you are a CPAP user, why type of mask do you use?

Nasal Mask
Full face mask

Have you had surgery for sleep issues?

Yes, I have had surgery for any sleep issues
No, I have not had surgery for any sleep issues

How is your mood generally?

Angry
Anxious
Irritable
Depression
Nervous
Stressed
Sad

Do you have any of the following cardiovascular issues?

Hypertension/high blood pressure
Hypotension/low blood pressure
Irregular heartbeat
Rapid heart rate
Heart rate too slow
Heart attack
Stroke

Do you have any of the following cognitive issues?

Difficulty concentrating
Headache
Mental fogginess
Migraines
Forgetfulnes

Do you experience any of the following?

Libido issues
Menstrual period issues
Pregnant
BMI
Chart (images)

Have you experienced any of the following dental conditions?

Tooth crowding
Teeth removed (specifically to make space for braces)
Missing teeth
High incidence of cavities
Gingivitis
Receding gums

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