Select the one that best describes your experience:
Restlessness, muscle tension, uncomfortable sensations, can't get comfortable in bed
Racing thoughts, can't turn off my brain, replaying the day, planning tomorrow
Anxiety, worry, stress about not sleeping, fear of another sleepless night
Understanding your timeline helps identify patterns:
Something changed recently and now I can't sleep well
It's been building up gradually over the past few months
I can't remember the last time I had consistently good sleep
Sometimes I sleep fine, other times it's terrible
Rate the impact on a scale of 1-5:
1 = Tired but functional | 5 = Can barely get through the day
Takes less than 60 seconds • No email required