Sleep Quality Assessment

1. How many hours do you typically sleep per night on weekdays? Select your answer Less than 5 hours 5-6 hours 6-7 hours 7-8 hours 8-9 hours More than 9 hours

2. How many hours do you typically sleep per night on weekends? Select your answer Less than 5 hours 5-6 hours 6-7 hours 7-8 hours 8-9 hours More than 9 hours

3. Do you maintain a consistent sleep schedule (go to bed and wake up at approximately the same time each day)?

4. How long does it typically take you to fall asleep? Select your answer Less than 15 minutes 15-30 minutes 30-60 minutes More than 60 minutes

5. How often do you wake up during the night?

6. How refreshed do you feel when you wake up in the morning?

7. Which of the following do you have in your bedroom? (Select all that apply)

8. Do you use electronic devices (phone, tablet, computer, TV) within 1 hour before going to bed?

9. Do you consume any of the following within 4-6 hours of bedtime? (Select all that apply)

10. Do you exercise regularly?

11. How would you rate your daily stress level?