During the past month, what time have you usually gone to bed at night?
Choose Time
During the past month, how long (in minutes) has it usually taken you to fall asleep each night?
Enter Minutes
During the past month, what time have you usually gotten up in the morning?
Choose Time
During the past month, how many hours of actual sleep did you get at night?
(This may be different than the number of hours you spent in bed.)
Enter Hours
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How often do you forget names or appointments?
How easily do you get distracted while working on a task?
How often have you felt down or depressed?
How often do you engage in physical exercise?
How would you rate the quality of your sleep?
how would you rate your overall sleep quality
How long does it usually take you to fall asleep?
how many hours of sleep do you typically get each night?
how often do you experience trouble sleeping due to waking up during the night?
How often do you feel tired or have trouble staying awake during the day?
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