Self-Assessment Of Sleep Quality

SleepWell® Program

Week 2

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There are probably many reasons for your poor sleep. This guide will take you through factors that you can modify to improve the likelihood of getting quality sleep. Even if you have a medical issue or take medication that impairs your sleep, addressing these lifestyle factors may help improve your sleep.

Download the pdf file to the left to take the Self-Assessment. These questions are designed to get you thinking about factors that may impact your sleep. Be honest with yourself. Each part of this survey will be discussed throughout the guide. If you are working with a coach, these questions can help guide your coach and help him or her tailor the SleepWell®program to your specific needs and goals.

This assessment is not intended to diagnose a serious sleep problem and does not take the place of expert medical assessment or treatment. This is a guide to determine if poor sleep may be a problem for you and if addressing lifestyle factors and certain behaviors could improve your quality of sleep. If you have insomnia for three weeks or longer, consult your health care provider.

© American Institute for Preventive Medicine