During the past month, how long has it usually taken you to fall asleep each night? (minutes)
During the past month, what time have you usually gotten up in the morning? (minutes)
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)(hours)
During the past month, how often have you had trouble sleeping because you:
During the past month, how often have you taken medicine to help you sleep (prescribed or 'over the counter')?
During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?