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Daily Routine Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

Time I woke up

Please indicate the time you woke up each day.
2

Time I got out of bed

Please indicate the time you got out of bed each day.
3

Time I went to bed

Please indicate the time you went to bed each day.
4

Time I fell asleep

Please indicate the time you fell asleep each day.
5

Did I use technology 1 hour before sleep?

Indicate whether you used technology (e.g., phone, TV) 1 hour before sleep each day.
6

What technology did you use?

Specify the technology (e.g., phone, TV) you used if you answered 'Yes' in the previous question.
7

Total hours of sleep

Please indicate the total hours of sleep you had each day.
8

Overall, how would you rate your sleep quality?

Rate your sleep quality on a scale of 1 to 10, with 1 being the lowest and 10 being the highest.
9

How energized did you feel upon waking up?

Rate your level of energy upon waking up on a scale of 1 to 5, with 1 being very low and 5 being very high.
10

Any additional comments about your daily routine or sleep patterns?

Feel free to provide any extra details or comments about your daily routine and sleep patterns.
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