Athlete Sleep Screening Questionnaire Form
Complete this screening to help assess your sleep habits and understand how they may impact your athletic recovery. All questions relate to your typical routines and recent experiences.
Full Name
*
First Name
Last Name
Age
*
Gender
Male
Female
Prefer not to say
How many days per week do you typically train?
*
Please Select
1-2 days
3-4 days
5-6 days
7 days
On average, what time do you usually go to bed?
*
Hour Minutes
AM
PM
AM/PM Option
On average, what time do you usually wake up?
*
Hour Minutes
AM
PM
AM/PM Option
How many hours of sleep do you typically get per night?
*
Please Select
Less than 5 hours
5-6 hours
6-7 hours
7-8 hours
More than 8 hours
How would you rate your overall sleep quality in the past week?
*
1
2
3
4
5
How often do you experience sleep disruptions (such as waking up during the night)?
*
Never
Rarely (1-2 times per week)
Sometimes (3-4 times per week)
Frequently (5 or more times per week)
Which of the following best describes your pre-sleep habits? (Select all that apply)
Use electronic devices (phone, tablet, computer) within 1 hour before sleep
Consume caffeine within 6 hours before sleep
Engage in relaxation techniques (e.g., meditation, stretching)
Read or listen to calming music
Other
How often do you feel sleepy or fatigued during the day?
*
Never
Rarely
Sometimes
Often
To what extent do you feel your sleep impacts your athletic recovery?
*
No impact
1
2
3
4
Major impact
5
1 is No impact, 5 is Major impact
Submit
Should be Empty: