Sleep

I wake up

Please select all that apply.

• in the middle of the night
• with an alarm clock
• naturally without an alarm clock

What do you do help you fall asleep at night?

Please select all that apply.

• drink an alcoholic beverage
• nothing I always sleep well
• drink a glass of milk
• take a hot bath
• other
• take medication

The length of my nap is

Please select all that apply.

• about an hour
• zero
• 20-30 minutes
• 2-3 hours

Do you like naps?

• yes
• no
• I am too busy to take a nap

How much sleep do you need to feel well rested?

• 6-8 hours
• less than 6 hours
• more than 10 hours
• 8-10 hours

The typical time I get up in the morning is

Please select all that apply.

• 5 am
• 10 am
• 8 am
• 6 am
• 9 am
• other
• 7 am

When I wake up in the middle of the night and I can't sleep I most frequently

Please select all that apply.

• watch TV
• get on the computer
• read a book
• get up and eat or drink something
• I don't, I sleep through the night
• lie in bed
• other

How often do you take a nap?

• 2-3 times a week
• every day
• never
• once a week

My bedtime is

Please select all that apply.

• 9 pm
• 8 pm
• 11 pm
• 10 pm
• other
• 12 am or later