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Your Insomnia Self Assessment
Why do I need to do this? A good question. Well, you know the saying "Know thy enemy"? The same is true of insomnia. If you don't know why you have it, you will have a devil of a job finding a cure. Your insomnia self-assessment is designed to help you learn about your own condition as it is at the moment.
Please print this page and fill it in every day. Then order your CD or mp3 and print off some more copies. Fill these in every day for the week after you start listening to your CD or mp3. Compare the two.
What will you notice and what will you learn about your insomnia? Certainly your understanding and awareness will increase. Your stress levels will drop because nothing is more relaxing than success. Your energy levels will improve and you will feel more in control and empowered.
1. Time I went to bed ___________ 2. Time the lights went out ___________
3. Before retiring, I read, watched TV, prayed, talked (or any other activity) for ___________
4. How long would you say it took you to drop off to sleep? (just guess) ___________
5. Did you wake up in the night? Yes/No 6. How many times? ___________
7. What woke you this morning (sunshine, alarm, noise etc.)? ___________
8. What time was that? ___________ 9. How long before you actually got up? ___________
10. I think I got ___________ hrs sleep last night.
11. Was that more or less than you thought, or need, or was it about right? ___________
12. Using 0-10 scale, rate the quality of your night's sleep.
(circle) 0 = lousy 1 2 3 4 5 6 7 8 9 10 = excellent
13. Did you take any sleeping medication of any kind? Yes/No What did you take? ___________
14. Is there anything that happened during the day that caused you to worry? ___________
Other things that will have an effect on your sleep patterns include: exercise, a sedentary lifestyle, sunlight, darkness, caffeinated drinks, medication, alcohol, smoking, traffic noise, other noise, snoring (your's or your partner), stress, anxiety, worry, heat, cold, general comfort, grief, anger, rapid heartbeat, headaches, pain, upset stomach, and I'm sure there are lots more.
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Why not give yourself the best chance of having a good nights sleep by ordering your Sleep Soundly Now! CD and put the odds back in your favour? You'll be very glad you gave this a try, that I can promise you!
Printing tip: To print this page on a sheet of A4, first select 'Print Preview' from your browser and then just opt to print page 1. You will get all of the self-assessment table on your sheet and none of the remainder. Doing our bit for the environment: every page counts!
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