How long does it usually take you to fall asleep at night?

How many hours of actual sleep do you get per night on average?

How often do you wake up during the night and cannot get back to sleep?

How often do you feel too hot or too cold while trying to sleep?

How often does noise, light or discomfort disturb your sleep?

How often do you take medication to help you sleep?

How often have you had trouble staying awake while driving, eating, or socializing?

How often have you had difficulty keeping up enthusiasm to get things done?

Chance of dozing: Sitting and reading

Chance of dozing: Watching TV or a screen

Chance of dozing: Sitting in a public place (meeting, theater)

Chance of dozing: As a passenger in a car for one hour

Chance of dozing: Lying down to rest in the afternoon