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Patients with complaints of Insomnia will see a sleep physician to assess the patient’s sleep history and complaints. Insomnia may be caused by many outside influences (time change, jet lag, life changing event) or may be a result of sleep disorder. The physician may ask you some of the following questions or ask you to complete a questionnaire with some of the questions listed below.

  1. Were there any stressful events related to the onset of your sleep difficulty?
  2. Do you have trouble falling asleep?
  3. Do you have trouble staying asleep?
  4. How many nights per month do you have problems falling asleep?
  5. 0-1 night  2-3 nights  4-5 nights  >6 nights
  6. When you wake up in the night, how long do you stay awake? _______________________
  7. Do you wake up early in the morning unable to go back to sleep?
  8. Do you worry about not being able to go to sleep?
  9. Do you look forward to going to sleep?
  10. Do you feel apprehension, anxiety or dread when you are getting ready to go to sleep?
  11. Do you have racing thoughts that prevent you from sleeping?
  12. Do you look at the clock to check the time when you cannot sleep?
  13. On a typical night, how many times do you wake up? __________________________
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