Do you have difficulty falling asleep at night'
0 Yes, often
0 Yes, occassionally
0 No ? y
Check any of the following that apply to you most nights:
0 Nightmares
0 Tossing/turning
0 Frequent waking ^
How often do you feel tired and run-down? /
0 Most of the time
0 Occassionally
0 Rarely