Sleep Quality Assessment

Before You Begin

Please read these important instructions to ensure you get the most accurate results from your assessment.

Answer Honestly

There are no right or wrong answers. Be truthful about your experiences.

Take Your Time

Read each question carefully and think about your response.

Complete All Questions

Answer all 10 questions for accurate results.

Privacy Protected

Your responses are completely confidential and secure.

Estimated Time

This assessment takes approximately 8 minutes.

Can Pause Anytime

You can pause and resume the assessment at any time.

Questions

Minutes

Wellness

How would you rate your overall sleep quality?

Very Poor Poor Fair Good Very Good

Question 1 of 10

How long does it usually take you to fall asleep?

Less than 15 minutes 15-30 minutes 30-60 minutes More than 60 minutes

Question 2 of 10

How often do you wake up during the night?

Never Once 2-3 times More than 3 times

Question 3 of 10

How often do you have trouble falling back asleep after waking up?

Never Rarely Sometimes Often

Question 4 of 10

How often do you wake up feeling refreshed?

Never Rarely Sometimes Often

Question 5 of 10

How often do you feel sleepy during the day?

Never Rarely Sometimes Often

Question 6 of 10

How often do you use electronic devices before bedtime?

Never Rarely Sometimes Often

Question 7 of 10

How often do you have caffeine in the afternoon or evening?

Never Rarely Sometimes Often

Question 8 of 10

How often do you exercise regularly?

Never Rarely Sometimes Often

Question 9 of 10

How often do you maintain a consistent sleep schedule?

Never Rarely Sometimes Often

Question 10 of 10

Question 1 of 10

Complete