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Insomnia - v2

Page One

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Which therapist referred you?
Before going to bed, which of the following have you ever done in order to help you get sleepy?
When in bed, prior to going to sleep or during the night if you have difficulty sleeping, do you...Choose all that apply.
Do you sleep with another person or a pet?
Does your bed partner ever cause you to have problems sleeping?
What size is your bed?
Number of minutes (whole number with no decimal point). This question requires a valid number format.
Number of minutes (whole number with no decimal point). This question requires a valid number format.
When you are in bed and awake, do you think about...Choose all that apply.
Do you ever become annoyed or angry when you cannot get to sleep?
Do you sometimes get out of bed if you cannot get to sleep?Please use the comments field to describe how often you do that, under what circumstances, and what you do if you get out of bed.
How long do you wait before getting up?
As your bedtime approaches, do you become more alert?
During the day, do you worry about getting to sleep the next night?
This question requires a valid number format.
This question requires a valid number format.
If you sleep away from home for a night or two do you: