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Sleeping Habits & Problems

Page One

1. Please select your Age group

2. What is your gender?

3. In a normal daily situation, by what means do you use to wake up? (Tick all applicable)

Alarm Clock
Radi + Alarmclock Combination
Mobile Phone Alarm
Mobile Phone Application (Such as "Sleep Cycle")
Natural/Artificial Light
Woken up by another person
Other

4. On a normal daily schedule, how long time does it usually take from the first alarm goes off until you get out of bed?

5. On a daily schedule, how would you describe your first hours after waking up?

7. Write down the first word that comes to your mind when you think of "Relaxation"

8. Select below under what environmental contions you would like to sleep.

1 = Least Preferred
8 = Most preferred Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5	6	7	8
Complete Darkness	1	2	3	4	5	6	7	8
Some Light	1	2	3	4	5	6	7	8
Complete silence	1	2	3	4	5	6	7	8
Some noise	1	2	3	4	5	6	7	8
Windows Open	1	2	3	4	5	6	7	8
Windows Closed	1	2	3	4	5	6	7	8
Chilly Room	1	2	3	4	5	6	7	8
Warm Room	1	2	3	4	5	6	7	8

9. On a normal daily schedule, do you use pharmaceutical aid to sleep?