1. How many hours of sleep do you generally get?
2. Do you find it difficult to fall asleep at night? yes/no
3. Do you snore while you are sleeping? yes/no
4. When you wake up, do you feel that you got a good sleep? yes/no
5. Do you usually remember your dreams? yes/no
6. Do you dream in color/black and white?
7. Do your dreams ever continue in a series of dreams? yes/no
8. Have you ever had a dream that came true? yes/no
9. Have you ever dreamed about (check all that apply):
~ being abandoned ~nature
~ being afraid ~ teeth
~ death ~ flying
~ falling ~ being naked
~ walking ~ fog
~ being chased ~ jail