Questionnaire for Sleep Disturbance - H. Frei, 2014

  To enable us to find a suitable homeopathic remedy,
  we need you to precisely record here all changes in how you feel which have arisen during the current illness.
  Click below whatever applies to you during your illness.


Open Air / Weather / Temperature / Wrapping up

● open air worse better
● open air desire for aversion to
● cold weather worse better
● wet cold weather worse
● warm weather worse better
● wet weather worse better
● dry weather worse better
● cold in general worse better
● warmth in general worse better
● when getting cold worse better
● wrapping up warmly worse better
● uncovering worse better
● warm room worse better
● becoming warm in bed worse better
● during perspiration worse better
● after perspiration worse better
● wet compress on body worse better
● getting wet worse
● worse wind draught
● getting hot want to uncover want to stay covered up
● getting perspiring want to uncover want to stay covered up


Position

● lying on back worse better
● lying on side worse better
● lying on painful side worse better
● change of position worse better
● sitting up / straightening up worse better


Movement / Exercise / Rest

● breathing deeply worse better
● physical exercise worse better
● mental effort worse better
● resting worse better


Eating / Drinking / Talking

● thirst thirsty absence of thirst
● appetite hunger loss of appetite
● after eating worse better
● cold food and drink worse better
● warm food and drink worse better
● after drinking worse better
● cold water worse better
● beer worse better
● wine worse better
● alcohol worse


Sensation

heart palpitations breathing anxious
● inside body full feeling cramps
● touch worse better
● external pressure worse better
● rubbing worse better


Sleep

● falling asleep late symptoms witch prevent
● sleep anxious deep
stupefying too long
unrefreshing restless
● sleeplessness before midnight after midnight
with sleepiness caused by complaints
● waking up often during night too early
too late
● unable to fall asleep after waking once
● sleepiness in daytime in morning
before noon in afternoon
in evening caused by complaints
● sleep excessive need to drowsy
● loss of sleep worse
● yawning in general spasmodic
● after lying down worse better
● while falling asleep worse better
● during sleep worse better
● while waking up worse better
● children's teething worse
● worse head cold pregnancy
● menstruation worse before at start of
during after
● worse full moon new moon
anger grief, sorrow
insult rage
fright, anxiety, fear


Typical dreams

● dreams anxious pleasant
persistent


State of Mind

● (unusual) irritable mild
● (unusual) sad happy
● being alone worse better


Please note further important symptoms in your mail, if they are not in this list.


Please click on 'Save' after a last control.
Thanks a lot!