1. Do you get drowsy after meals?
A. Rarely
B. After breakfast or dinner
C. After lunch

2. How long does it take you to fall asleep at night?
A. 10-15 minutes
B. 5-10 minutes
C. Less than 5 minutes

3. On weekends, do you . . . ?
A. Sleep same amount as during the week
B. Sleep longer

4. How many nights a week do you feel you don't get enough sleep?
A. Zero B. 1-2 nights
C. 3-4 nights D. 5-7 nights

5. In the morning, you . . .
A. Get up without being awakened by an alarm, etc.
B. Need to be awakened
C. Keep hitting the snooze button

6. You get sleepy . . . (indicate all answers which apply to you)
A. Only at bedtime
B. When a passenger (car, airplane, etc.)
C. Reading or watching television
D. In meetings or at movies
E. When stopped in traffic

7. Do you snore?
A. Never
B. Sometimes
C. Often and loudly

8. What is your age?
A. 16-29 years
B. 30-60 years
C. 61 + years

9. You are getting off work and you are worn out. What do you do?
A. Hit the road right away
B. Relax, stop for a happy hour "attitude adjustment" drink
C. Stop for a meal including 1 (no more than 2) drinks

10. Your drive home after work is . . .
A. Short or you don't drive
B. Country roads
C. City/suburban streets
D. Freeways

11. It's late Friday night and you're leaving on vacation. Your destination is a 6 hour drive away. What do you do?
A. Wait until morning to leave
B. Nap, get up and leave at 3:00 a.m.
C. Drive through the night

12. When driving, you feel yourself getting drowsy. You decide to stop for a bite to eat. What do you have?
A. 1 or 2 cups of coffee
B. Fast food
C. Sugar-loaded snacks
D. A full meal

13. You realize you are getting drowsy and decide to turn on the radio to wake yourself up. What do you listen to?
A. Mellow music
B. Loud, energetic music
C. Talk show/sports

14. What do you do to stay awake? (Circle all which apply)
A. Pull over and get some exercise
B. Slap yourself in the face
C. Talk or sing
D. Blast the air conditioner
E. Open the window

15. You are 2 hours into a 6 hour drive and your eyes are feeling heavy. What do you do?
A. Stop immediately and take a long nap
B. Fight it as long as you can, then pull over and take a long nap
C. Take a short "catnap"
D. Just get off the road for a few minutes

Answer Sheet