* 1. How long does it typically take you to fall asleep each night?

* 2. How many hours of sleep do you get each night, on average, during the week?

* 3. How many hours of sleep do you feel you need each night to be at your best?

* 4. How often do you typically awaken during the night?

* 5. Do you wish you could get more sleep?

* 6. What is your age group?

* 7. When the alarm goes off in the morning, how do you feel?

* 8. Do you feel like you need a nap during the day?

* 9. In the past year, have you suffered from insomnia or an inability to get enough sleep?

* 10. When you have trouble falling or staying asleep, what do you do?

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