Children’s Sleep and Bed Wetting Questionnaire

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Does your child suffer from a significant health problem?
Does your child have a regular bedtime hour?
Where does your child fall asleep
Does your child refuse going to bed?
How much time does it take your child to fall asleep?
Does your child wake up during the night restless, not awake, usually after about 2-3 hours from bed time (cries, angry, moving his arms or legs restlessly)
Does your child have fears at bedtime or during the night?
If your child has fears does he/she need parental reassurance to calm down and fall asleep?
Does your child snore or sleep with his/her mouth open?
Is your child sleepy or very tired during the day?
How many times does your child wake up during the night?
Does your child have nightmares?
Does your child wet his/her bed at night?
Was there a period of complete dryness at night for at least 6 months?
Does your child wet only during the night?
Do you limit liquids before going to sleep or wake your child during the night to go to the toilet?
Did you try any of these treatment methods?
Did you rule out any medical condition regarding bed wetting? (copy)