| |
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
| |
|
|
|
|
|
| |
| |
|
|
|
|
|
| |
| |
|
|
|
|
|
| |
| What things affect your sleep? |
| |
|
|
|
|
|
| How many of the following caffeinated beverages do you drink on average each day?
|
|
|
|
|
|
| |
| Do you use tobacco or tobacco products? |
| |
|
|
|
|
| |
| Do you take any prescribed or over-the counter medications that affect sleep? (For example: melatonin, energy shots, etc) |
| |
|
|
|
|
Loading...
