Sleep Questionnaire

You are here:
  1. Home
  2. Sleep Questionnaire

We appreciate you taking a few moments to complete this questionnaire. Your answers will play a crucial role in enhancing our understanding of your present sleep situation.

Sleep Questionnaire

  • Your ID number can be found on the letter your received containing this link
  • If retired enter last occupation
  • If yes, please select which type of driver suits you
  • Highly likely (score=3)Moderately likely (score=2)Slightly likely (score=1)Never (score=0)
    Sitting and reading
    Watching TV
    Sitting, inactive in a public place eg Theatre or meeting
    As a passenger in a car for an hour without a break
    Lying down to rest in the afternoon when circumstances permit
    Sitting and talking to someone
    Sitting quietly after lunch (no alcohol)
    In a car, while stopped for a few minutes in the traffic
    This survey is a simple measure of how sleepy you are during the day. They are not a measure of how fatigued you are. It is a measure of sleepiness. On an ordinary day (assume you are not at work) in the noted situations, how likely are you to doze off to sleep?