Step 1 of 28 3% 2aDoes your child have a regular bedtime (within 30 minutes every night)? Yes No/ not sure 2bDoes your child have a regular waking time (within 30 minutes every morning)? Yes No/ not sure 3aIs your child's bedroom media free (e.g. no iPad/TV/Laptop)? Yes No/ not sure 4aIs your child's bedroom cool, quiet and relatively dark? Yes No/ not sure 5aDoes your child have caffeine after 3pm (e.g. chocolate, tea, coffee, cola)? Yes No/ not sure 6aDoes your child do any stimulating activities (e.g. sports) or have any screen time (e.g. computer games, TV, iPad) in the hour before bed? Yes No/ not sure 7aDoes your child have problems going to sleep at the start of the night? Yes No/ not sure 8aDoes your child come in and out of their room or call out a lot before falling asleep? Yes No/ not sure 8b1Does your child need to do an activity to fall asleep (e.g. watch TV, play ipad etc)? Yes No/ not sure 8b2Does your child need a parent-specific item (such as a dummy, music etc) to fall asleep? Yes No/ not sure 8b3Does your child need a person (mum, dad etc) to fall asleep? (Including feeding to sleep) Yes No 8dDoes your child report an uncomfortable feeling in their legs, or moves them a lot, at the start of the night? Yes No 9aDoes your child fall asleep within 30 minutes of going to bed? Yes No 10aDoes your child worry at bedtime or worry about going to sleep? Yes No/ not sure 11aDoes your child wake up on their own at the start of the day? Yes No/ not sure 12aDoes your child sleep in late in the morning if given the chance? Yes No/ not sure Hidden12ai 13aDoes your child have problems with waking during the night? Yes No/ not sure 14a1If your child wakes overnight, do they need an activity (e.g. watch TV, play a game) to fall back asleep? Yes No/ not sure 14a2Does your child require an item (dummies, music etc) to fall back to sleep? Yes No/ not sure 14a3Does your child need a person present (mum, dad etc) to fall back asleep? Yes No 14cDoes your child report a restlessness of their legs when in bed? Yes No 14dDoes your child suddenly become agitated, perhaps crying or screaming, looking panicked, sweating and does not respond to soothing or comforting overnight? Yes No/ not sure 14d2Does this happen around the same time each night? Yes No 14eDoes your child wake up overnight by frightening dreams? Yes No 14f1Does your child get out of bed overnight and walk around as if awake but not respond to you, and not remember it in the morning? Yes No 14f2Does your child have a conversation with you overnight but not remember it in the morning? Yes No 15Is it a problem that your child consistently wakes up before 6am in the morning? Yes No/ not sure 15b15b. Does your child get screen time or iPad/TV or other "treat" when they wake up in the morning? Yes No/ not sure Δ
