Sleep Assessment Quiz Sleep Assessment Quiz On a scale of 1 - 5, (1 being least frequent and 5 being the most frequent) how often do you experience these symptoms? Q1 Do you have trouble falling asleep? 1 2 3 4 5 Q2 Do you have trouble staying asleep? 1 2 3 4 5 Q3 Do you take anything to help you sleep? 1 2 3 4 5 Q4 Do you take alcohol to help you sleep? 1 2 3 4 5 Q5 Do you experience trouble sleeping due to any medical conditions? 1 2 3 4 5 Q6 Do you have to work shifts or is your sleep schedule irregular? 1 2 3 4 5 Q7 Do you experience restlessness and/or discomfort in your legs just before bed? 1 2 3 4 5 Q8 Have you been told that you are restless or that you kick your legs in your sleep? 1 2 3 4 5 Q9 Do you have any unusual behaviours or movements during sleep? 1 2 3 4 5 Q10 Do you snore? 1 2 3 4 5 Q11 Have you been told that you stop breathing, gasp, snort or choke in your sleep? 1 2 3 4 5 Q12 Do you have difficulty staying awake during the day? 1 2 3 4 5 Q13 Have you lost interest in activities you previously found enjoyable? 1 2 3 4 5 Q14 Do you feel sad, irritable, hopeless or helpless? 1 2 3 4 5 Q15 Do you feel more anxious or worried? 1 2 3 4 5 Q16 Do you think something is wrong with your body? 1 2 3 4 5 Show Results Website