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Questionnaire Name - Sleep & Your Life

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1	Gender
	A- M (92)  B- F (125)
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2	Age
	A- Under 18 (37)  B- 18~24 (97)  C- 25~40 (44)  D- 41 or above (39)
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3	Occupation
	A- Student (121)  B- At Work (69)  C- Unemployed (27)
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4	What time do you usually go to bed?
	A- Before 10pm (9)  B- 10pm~11pm (33)  C- after 11pm~12am (66)  D- after 12am (109)
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5	How long does it take you to fall asleep when you are in bed?
	A- Less than 5 minutes (26)  B- 5~10 minutes (94)  C- 11 minutes or above (97)
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6	How many hours do you usually sleep on weekdays?
	A- 2~3 hours (4)  B- 4~6 hours (129)  C- 7 hours or above (84)
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7	How many hours do you usually sleep on weekends?
	A- 2~3 hours (3)  B- 4~6 hours (39)  C- 7 hours or above (175)
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8	How often do you wake up during the night?
	A- Never (82)  B- 1~2 times (123)  C- 3 times or above (12)
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9	Do you have nightmares or bad dreams?
	A- Yes(Go to Q.10) (120)  B- No(Go to Q.12) (97)
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10	How often do you have them per month on average?
	A- 1~2 times (87)  B- 3 times or above (39)
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11	What do you think is causing you to have sleeping disorder?
	A- Pressure (97)  B- Diseases (5)  C- Life Style (52)  D- Environment (27)  E- Others (2)
	No Selection (91)   Select 1 item (79)   Select 2 items (37) Select 3 items (10)   Select 4 items (0) Select 5 items (0)
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12	Have you ever tried to take medicine that help you sleep well?
	A- Yes (22)  B- No (195)
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13	Do you often wake up tired?
	A- Yes (143)  B- No (74)
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14	Do you feel refreshed when you wake up?
	A- Yes (106)  B- No (111)
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15	Do you sleep walk?
	A- Yes (7)  B- No (210)
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16	Do you sleep talk?
	A- Yes (40)  B- No (177)
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17	Do you feel tired/fall asleep during the day?
	A- Always (34)  B- Sometimes (136)  C- Rarely (43)  D- Never (4)
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18	Do you find it hard to maintain concentration during the day?
	A- Yes (78)  B- No (139)
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19	Do you feel that you forget things easier after sleeping less at night?
	A- Yes (115)  B- No (102)
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20	Do you have to drink energy drinks (e.g. Red Bull, Coffee) to keep yourself awake?
	A- Yes (72)  B- No (145)
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