Bedtime Problems

Child: Do you have any problems falling asleep at bedtime?* Child: Do you have any problems falling asleep at bedtime?* Yes No

Excessive Daytime Sleepiness

Child: Do you feel sleepy a lot during the day?* Child: Do you feel sleepy a lot during the day?* Yes No

Child: Do you feel sleep while in school?* Child: Do you feel sleep while in school?* Yes No

Child: Do you feel sleepy while driving?* Child: Do you feel sleepy while driving?* Yes No

Awakenings During the Night

Child: Do you wake up a lot at night?* Child: Do you wake up a lot at night?* Yes No

Child: Do you have trouble getting back to sleep?* Child: Do you have trouble getting back to sleep?* Yes No

Regularity and Duration of Sleep

Child: What time do you go to bed and get up on school days?*

Child: Weekends?*

Child: How much sleep do you usually get?*

Snoring

Parent: Does your teenager snore loudly or nightly?* Parent: Does your teenager snore loudly or nightly?* Yes No

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