Adrenal stress profile questionnaire

Next to each question assign a number between 0 and 5. You should assign values as follows:

0 = Not true 3 = Somewhat true 5 = Very true

Once you have completed the questionnaire calculate your total and locate the range you fall under on page two.

Questions            
1. I experience problems falling asleep. 0 1 2 3 4 5
2. I experience problems staying asleep. 0 1 2 3 4 5
3. I frequently experience a second wind (high energy) late at night. 0 1 2 3 4 5
4. I have energy highs and lows throughout the day. 0 1 2 3 4 5
5. I feel tired all the time. 0 1 2 3 4 5
6. I need caffeine (coffee, tea, cola, etc) to get going in the morning. 0 1 2 3 4 5
7. I usually go to bed after 10 pm. 0 1 2 3 4 5
8. I frequently get less than 8 hours of sleep per night. 0 1 2 3 4 5
9. I am easily fatigued. 0 1 2 3 4 5
10. Things I used to enjoy seem like a chore lately. 0 1 2 3 4 5
11. My sex drive is lower than it used to be. 0 1 2 3 4 5
12. I suffer from depression, or have recently been experiencing feelings of depression such as sadness, or loss of motivation. 0 1 2 3 4 5
13. If I skip meals I feel low energy or foggy and disoriented. 0 1 2 3 4 5
14. My ability to handle stress has decreased. 0 1 2 3 4 5
15. I find that I am easily irritated or upset. 0 1 2 3 4 5
16. I have had one or more stressful major life events. (ie: divorce, death of a loved one, job loss, new baby, new job) 0 1 2 3 4 5
17. I tend to overwork with little time for play or relaxation for extended periods of time. 0 1 2 3 4 5
18. I crave sweets. 0 1 2 3 4 5
19. I frequently skip meals or eat sporadically. 0 1 2 3 4 5
20. I am experiencing increased physical complaints such as muscle aches, headaches, or more frequent illnesses. 0 1 2 3 4 5