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Diagnose Your Sleep!

 

 

 

Here we go...

Start

Question 1 of 30

First, just a couple of quick questions about you. What is your age?

A

Under 18

B

18 - 24

C

25 - 34

D

35- 44

E

45 - 54

F

55 - 64

G

65 - 74

H

75 and over

Question 2 of 30

And what best describes your gender?

A

Female

B

Male

C

Non-binary

D

Prefer not to say

Sleep Duration & Quality

Part 1

Question 4 of 30

In the last month, the amount of sleep I have had per night, on average, is around....

A

Less than 3 hours

B

3-6 hours

C

6-7 hours

D

7-9 hours

E

9-10 hours

F

More than 10 hours

Question 5 of 30

In the last month, I feel that  the quality of my sleep has been....

A

Terrible

B

Poor

C

Average

D

Good

E

Excellent

Question 6 of 30

I struggle to fall asleep on at least 3 nights per week

A

Yes

B

No

Question 7 of 30

Once I've fallen asleep I struggle to stay asleep, and this happens at least 3 nights per week

A

Yes

B

No

Question 8 of 30

I wake during the night and struggle to get back to sleep due thinking or worrying about problems in my life, and this happens at least 3 nights per week

A

Yes

B

No

Question 9 of 30

I have poor quality sleep which impairs my daytime functioning, on at least 3 nights per week

A

Yes

B

No

Question 10 of 30

I find myself frequently worrying, and find that repeated thought patterns can disturb my sleep

A

Yes

B

No

Sleep Environment & Sleep Patterns

Part 2

Question 12 of 30

My sleep is affected or disturbed by any of the following:

(Select all that apply)
A

Babies under 6 months of age

B

Babies aged 6-12 months

C

Infants aged 1-2 years

D

Children aged 2 or above

E

Hot flushes or menopause symptoms

F

Depression, anxiety or other mental health condition

G

Shift working, or a job that has unusual hours

H

My partner

I

Chronic pain

J

Noise and/or light pollution which I cannot do anything about

K

Pets

L

None of these

Question 13 of 30

If your sleep is disturbed by babies and/or children, how significant are these disruptions?

A

They are the main or only cause of my sleep disruption

B

They are a significant cause of my sleep disruption, but not the only cause

C

They contribute to my sleep disruption, but other factors are more signficant

D

They are a minimal cause of sleep disruption, it's not really a problem

E

Not applicable to me - my sleep is not disturbed by babies or children

Question 14 of 30

Imagine you were well rested and had no work, school, caring responsibilities, or any other obligations.

When would your body's natural preference be to go to bed?

A

Earlier than 9pm

B

9pm - 10pm

C

10pm - midnight

D

Midnight - 1am

E

Later than 1am

Question 15 of 30

Still imagining you are well rested, with no work, school or caring responsibilities and no other obligations.

When would your body's preference be to wake up naturally, without an alarm?

A

Earlier than 6am

B

6am - 7am

C

7am - 9am

D

9am - 10am

E

Later than 10am

Daytime Sleepiness

Part 3

Question 17 of 30

On a typical day, I have a hard time staying awake while sitting and reading

A

Yes

B

No

Question 18 of 30

On a typical day, I have a hard time staying awake while watching TV

A

Yes

B

No

Question 19 of 30

On a typical day, I have a hard time staying awake while sitting at work, or in a public place

A

Yes

B

No

Question 20 of 30

On a typical day, I have a hard time staying awake while sitting as a passenger in a car

A

Yes

B

No

Question 21 of 30

On a typical day, I have a hard time staying awake while sitting and talking to someone

A

Yes

B

No

Question 22 of 30

On a typical day, I have a hard time staying awake during situations that could have been dangerous (e.g. driving)?

A

Yes

B

No

Final Section

Part 4

Question 24 of 30

The following apply to me:

(Select all that apply)
A

My bed partner complains about how loudly I snore

B

I wake with a dry mouth in the mornings

C

I have been told that that I sometimes stop breathing for a short time in my sleep

D

I sometimes wake up at night choking or gasping for air

E

None of the above apply to me

Question 25 of 30

When I get angry, frightened or find something funny, I frequently experience sudden muscle weakness or unsteadiness where I might collapse to the floor

A

Yes

B

No

Question 26 of 30

At the moment of falling asleep or just waking up, I frequently experience scary hallucination-like images

A

Yes

B

No

Question 27 of 30

I have uncomfortable sensations in my legs, and/or an urge to move them, and this gets worse in the evenings and nights

A

Yes

B

No

Question 28 of 30

My sleep is disturbed by any of the following:

(Select all that apply)
A

Involuntary movement in my legs or body

B

Pauses in my breathing

C

Recurrent nightmares

D

Sleep-walking or other activities in my sleep

E

A sensation of being paralysed on waking from sleep

F

None of the above

Question 29 of 30

Final question!! 😁

The following apply to me:

(Select all that apply)
A

I seem to sleep OK at night but I still don’t feel my best during the day

B

I seem to sleep OK at night but I don’t feel rested when I wake up in the morning

C

I struggle to get in the hours of sleep I feel I need (e.g. due to work, hobbies, partying etc)

D

I often feel “tired and wired” and find it difficult to switch off

E

I struggle to lose weight, and/or I have cravings for unhealthy foods

F

I would like to optimise my sleep to improve my memory and brain performance

G

I would like to optimise my sleep to improve my physical performance

H

None of the above

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