When one has insomnia, there may be difficulty in falling asleep or staying asleep, or it may be that one wakes up too early and then can’t get back to sleep. It can also be a feeling of not refreshed after a night’s sleep. Most of the time it is a combination of one or more of these complaints. The severity of insomnia can be assessed by the “Insomnia Severity Index”.

Please answer the following questions based on your experience in the last two weeks.

For each question below, please circle the number corresponding most accurately to your sleep patterns in the LAST MONTH.