Sleep Survey Questions Survey

Your Sleep Habits 🌙

Tell us about your sleep over the past two weeks. A quick estimate is fine.

How much sleep do you usually get each night?*

If you sleep during the day, count your main sleep period instead.

Less than 5 hours
5 to less than 6 hours
6 to less than 7 hours
7 to less than 8 hours
8 to less than 9 hours
9 hours or more

How would you rate your sleep quality overall?*

Think about how well you slept, not just how long.

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5

Very poor to Very good

What has made it harder for you to sleep?

Select all that apply. Choose “Nothing” on its own.

Stress or worries
Noise, light, or room temperature
Work or school schedule
Caregiving responsibilities
Physical discomfort or health symptoms
Screen use near bedtime
Caffeine or alcohol
Other
Nothing

How long does it usually take you to fall asleep?*

Estimate from when you start trying to sleep.

Less than 15 minutes
15–30 minutes
31–60 minutes
More than 60 minutes
Not sure

How rested do you usually feel after waking up?*

Think about how you feel when you get up for the day.

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5

Not at all rested to Very rested

How often do you wake during sleep and struggle to fall back asleep?*

Count times when you stay awake for about 20 minutes or longer.

Never
Less than once a week
1–2 times a week
3–4 times a week
5 or more times a week

How consistent is your bedtime?*

Compare when you try to sleep from one day to the next.

Usually within the same 30-minute window
Usually varies by 31–60 minutes
Usually varies by more than 1 hour, up to 2 hours
Usually varies by more than 2 hours
I don’t have a usual bedtime

How much does sleepiness interfere with your daily activities?*

Consider work, school, household tasks, or time with others.

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5

Not at all to A great deal

What, if anything, would help you sleep better?

Share any changes or support you would find useful.

Thank you for taking a part in this survey.

This is a HeySurvey survey template.