PSQI

1. 1

   During the past month, how long has it usually taken you to fall asleep each night?

   ≤ 15 minutes · 16 – 30 minutes · 31 – 60 minutes · > 60 minutes
2. 2

   During the past month, on average, how many hours were you in bed each night (lights-off to wake-up)?

   > 8 hours · 7 – 8 hours · 6 – 7 hours · < 6 hours
3. 3

   During the past month, how many hours of actual sleep did you get at night?

   > 7 hours · 6 – 7 hours · 5 – 6 hours · < 5 hours
4. 4

   During the past month, how often have you had trouble sleeping because you cannot get to sleep within 30 minutes?

   sleep_latencyNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
5. 5

   …wake up in the middle of the night or early morning?

   sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
6. 6

   …have to get up to use the bathroom?

   sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
7. 7

   …cannot breathe comfortably?

   sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
8. 8

   …cough or snore loudly?

   sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
9. 9

   …feel too cold?

   sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
10. 10

    …feel too hot?

    sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
11. 11

    …had bad dreams?

    sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
12. 12

    …had pain?

    sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
13. 13

    …other reason(s) — please describe in a clinical interview.

    sleep_disturbanceNot during the past month · Less than once a week · Once or twice a week · Three or more times a week
14. 14

    During the past month, how often have you taken medicine (prescribed or over the counter) to help you sleep?

    Not during the past month · Less than once a week · Once or twice a week · Three or more times a week
15. 15

    During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?

    Not during the past month · Less than once a week · Once or twice a week · Three or more times a week
16. 16

    During the past month, how much of a problem has it been for you to keep up enthusiasm to get things done?

    No problem at all · Only a very slight problem · Somewhat of a problem · A very big problem
17. 17

    During the past month, how would you rate your sleep quality overall?

    Very good · Fairly good · Fairly bad · Very bad

Items reproduced from a documented, freely usable source. Item wording is preserved exactly as published.

Higher scores indicate greater symptom severity.