Form: Athens Insomnia Scale, AIS

1. Sleep induction (time it takes you to fall asleep after turning-off the lights):
No problem
Slightly delayed
Markedly delayed
Very delayed or did not sleep at all
2. Awakenings During the Night:
No problem
Minor problem
Considerable problem
Serious problem or did not sleep at all
3. Final Awakening Earlier than Desired:
Not earlier
A little earlier
Markedly earlier
Much earlier or did not sleep at all
4. Total Sleep Duration:
Sufficient
Slightly insufficient
Markedly insufficient
Very insufficient or did not sleep at all
5. Overall Quality of Sleep (no matter how long you slept):
No problem
Mild Problem
Moderate Problem
Severe Problem
6. Sense of Well-Being During the Day:
Normal
Slightly decreased
Markedly decreased
Very decreased
7. Functioning (Physical and Mental) During the Day:
Normal
Slightly decreased
Markedly decreased
Very decreased
8. Sleepiness During the Day:
None
Mild
Considerable
Intense