Please rate the current (i.e., last 2 weeks) SEVERITY of your insomnia problem - difficulty falling asleep

Please rate the current (i.e., last 2 weeks) SEVERITY of your insomnia problem - difficulty staying asleep

Please rate the current (i.e., last 2 weeks) SEVERITY of your insomnia problem - problem waking up too early

How satisfied/dissatisfied are you with your current sleep pattern?

To what extent do you consider your sleep problem to INTERFERE with your daily functioning?

e.g., daytime fatigue, ability to function at work/daily chores, concentration, memory, mood, etc.

How NOTICEABLE to others do you think your sleeping problem is in terms of impairing the quality of your life?

How WORRIED/distressed are you about your current sleep problem?