The Ultimate Sleep Quality Assessment
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Question 1/20
How long does it typically take for you to fall asleep after lying down?
Less than 10 minutes
10-30 minutes
31 minutes to an hour
More than an hour
Question 2/20
Do you often wake up in the middle of the night?
Never
Once
2-3 times
More than 3 times
Question 3/20
Do you use electronic devices (phone, computer) before bed?
Not at all
For about 10-30 minutes
30 minutes to an hour
More than an hour
Question 4/20
How often do you have trouble falling back asleep after waking up during the night?
Rarely or never
Occasionally
Often
Always
Question 5/20
Do you feel refreshed after waking up?
Always
Often
Sometimes
Rarely or never
Question 6/20
How often do you have vivid dreams or nightmares?
Rarely or never
Once a month
Once a week
Multiple times a week
Question 7/20
Do you consume caffeine (coffee, tea, soft drinks) in the evening?
Never
Rarely
Sometimes
Frequently or always
Question 8/20
How often do you nap during the day?
Rarely or never
Once a day
Multiple times
For more than 2 hours
Question 9/20
Do you maintain a consistent sleep schedule?
Always
Mostly
Sometimes
Rarely or never
Question 10/20
How would you rate your bedroom environment for sleep?
Very comfortable
Comfortable
Okay
Uncomfortable
Question 11/20
Do you engage in a bedtime relaxation routine (e.g., reading, meditation)?
Always
Often
Rarely
Never
Question 12/20
How often do outside noises disrupt your sleep?
Never
Rarely
Occasionally
Frequently
Question 13/20
How often do you sleep for 7-9 hours in a night?
Always
Often
Sometimes
Rarely or never
Question 14/20
Do you eat a large meal before bed?
Never
Rarely
Occasionally
Frequently
Question 15/20
Do you keep your bedroom dark while sleeping?
Always
Most of the time
Sometimes
Rarely or never
Question 16/20
How often does stress or anxiety prevent you from sleeping?
Rarely or never
Occasionally
Often
Always
Question 17/20
Do you exercise during the day?
Yes, regularly
A few times a week
Rarely
Never
Question 18/20
How often do you wake up with a dry mouth or a headache?
Never
Rarely
Sometimes
Often
Question 19/20
How often do you feel sleepy or doze off during the day?
Never
Rarely
Occasionally
Frequently
Question 20/20
Do you use sleep aids or medication to help you sleep?
Never
Occasionally
Often
Every night
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