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Sleep Deprivation Survey Template

The Sleep Deprivation Survey Template is designed to help you capture information about the sleeping patterns, sleeping habits, and the lifestyle of people to find out the reason behind the sleep deprivation.

Understanding the Sleep Deprivation Survey Template

Sleep deprivation and insomnia is a pivotal issue affecting the mental and physical health of people today. It can even affect their everyday life. Before diagnosing the same, one can collect information about their sleeping patterns, how troubled sleep has affected them, frequency of poor sleep, if they work in night shifts, and more.

The Sleep Deprivation Survey Template is designed keeping all such requirements in mind. It comprises 16 questions that ask the respondents different questions to analyze their issue. But first, this Sleep deprivation and academic performance survey questionnaire captures their basic details to help you understand them better. The Sleep deprivation questionnaire FOR students can be a part of your student feedback survey and ask questions about their sleeping habits like late nights, troubled sleeps, time taken to fall asleep, and more. It also captures data about their habits that could affect sleep like alcoholism, physical activity, and more.

You can use the Sleep Deprivation in Teenagers Survey Template by signing in or signing up with Zonka Feedback.

List of Sleep Deprivation Survey Questions

The following questions are included in this Sleep Deprivation Survey Template.

  • What's your name? 
    Let's start off with some basic personal details! 
  • Your email address?
  • Your phone number?
  • Your address? 
    Help us get to know you better. 
  • Your height?
  • Your gender?
  • Your weight?
  • How often has poor sleep troubled you in the last month?
  • How often do you feel sleepy in the day time while working?
  • How many nights do you think you get poor sleep, in a week?
  • Do you work in night shifts?
  • How long does it take you to fall asleep after hitting the bed?
  • Do you consider yourself to be an alcoholic?
  • How often do you exercise in a week?
  • How would you rate the quality of your sleep?
  • Do you have any additional comments/information for us?

Sign Up or Sign In on Zonka Feedback for free and try this Sleep Deprivation Survey Template to assess your patient's sleeping patterns and ease the process of diagnosing the issue of sleep deprivation.

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