Child Sleep Related Impairment Questionnaire

This measure is intended for children/adolescents ages 8 to 17 years old. Please respond to each item by selecting an option from each dropdown menu.

In the past 7 days...

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1. I was sleepy during the daytime.

2. I had a hard time concentrating because I was sleepy.

3. I had a hard time getting things done because I was sleepy.

4. I had problems during the day because of poor sleep.

5. I had trouble staying awake during the day.

6. It was hard to have fun because I was sleepy.

7. I could not keep my eyes open during the day.

8. I was in a bad mood because I was sleepy.