Rate the following Statements: 0 = never; 1 = sometimes; 2 = often; 3 = always

1. I sleep through the alarm clock……………………………… ___

2. I have morning grogginess…………………………………… ___

3. I need caffeine to help me wake up in the morning………… ___

4. I need caffeine to help me stay awake during the day……… ___

5. I have difficulty concentrating………………………………. ___

6. I turn down social engagements because of fatigue………… ___

7. It is difficult to keep my eyes open while driving at night…. ___

8. I fall asleep within 5 minutes of going to bed………………. ___

9. I am forgetful during the day……………………………….. ___

10. I am irritable with family members and co-workers…….. ___

11. It takes me longer to get things done……………………… ___

12. I experience the mid-afternoon slump……………………. ___

TOTAL: ______

Scoring Key:

0-9: No, you are not sleep deprived.

10-24: You are on the way to sleep deprivation.

25-36: Yes, you are sleep deprived.