Sleep Quality Survey
Please take a few minutes to complete this survey about your sleep quality.
On average, how many hours of sleep do you get per night?
Do you usually go to bed and wake up at consistent times?
Yes
No
Other
How would you rate your sleep quality?
Please Select
Excellent
Good
Fair
Poor
Do you experience difficulty falling asleep?
Yes
No
Other
How often do you wake up during the night?
Rarely
Sometimes
Often
Always
Do you feel refreshed and well-rested when you wake up in the morning?
Yes
No
Other
What is your sleep environment like?
Quiet and dark
Noisy and bright
Somewhere in between
Do you use any sleep aids or devices to improve your sleep?
Yes
No
Please describe any factors that may affect your sleep quality (e.g., noise, stress, temperature).
Submit
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