15/5/2020 LACK OF SLEEP

LACK OF SLEEP
Hello VGU freshman, my name is Uyen Vi from group D4. I am conducting this survey
to collect data on your sleep habits that lead to sleep deprivation. I ensure that the
information you supply is kept private and only be used for research purposes. It
takes you only a few minutes to fill all of the surveys.If you are unsure about which
response to give to a question, the first response you think of is often the best one.
Thank you for your co-operation.
* Required

LATE SLEEPING HABITS

1. What is your gender ? *

Mark only one oval.

Male

Femal

Other:

2. What is your major ? *

Mark only one oval.

BA

FA

EEI

ME

CS

Arch

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3. Do you consider yourself a night owl? *

Mark only one oval.

Ye

No

4. What time do you usually go to bed ? *

Mark only one oval.

Before 9 PM

Between 9 PM - 10 PM

Between 10 PM - 11 PM

Between 11 PM and

midnight Between 12:00

AM and 2 AM Other:

5. What is the reason you go to bed at this time ? *

Check all that apply.

Parents have set a

time I have set my
time
I finish studying or homework
I have to wake up early for
school I feel sleepy
Other:
15/5/2020 LACK OF SLEEP

6. How much sleep did you have recently ? *

Mark only one oval.

Below 6 hours

6-7 hours

Above 7

hours Other:

7. How long does it take you to fall asleep ? *

Mark only one oval.

I fall asleep immediately

I take about 10 mins to fall

asleep I take 10-20 mins to

fall asleep

Other:

8. Which of these problems have you had with your sleep? Select all that apply: *

Check all that apply.

Difficulty sleeping
Waking up in the middle of the night
Waking up in the middle of the night and can’t fall back to
sleep Difficulty waking up
Feel unrested on waking up
None of the above
Other:

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15/5/2020 LACK OF SLEEP

9. How many times in a week do you stay up late on a school night? *

Mark only one oval.

Once

2 or 3 times

4 times

More than 4 times

10. How much difficulty did you have in getting off to sleep last night? *

Mark only one oval.

None or very little

Some

A lot

Extreme difficulty

11. How many times do you usually wake up at night ? *

Mark only one oval.

Non

Onc

2 or 3 times

Above 3

times I have

no idea

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15/5/2020 LACK OF SLEEP

12. How clear-headed do you feel after getting up next morning? (please rate from
1 to 5) *

Mark only one oval.

1 2 3 4 5

Extremely bad Good

13. If you struggle to sleep, please state your agreement with the following
statements that are causing you to sleep less: *

Mark only one oval per row.

Disagree Neutral Agree

Nott compllettiing homeworrk Sttrress off a home assiignmentt Rellattiionshiip prrobllems
Excessiive use off phone/iintterrnett befforre slleepiing

Lack off physiicall acttiiviitty

Wakiing up tto go tto tthe batthrroom Annoyiing sounds

Temperratturre iin tthe rroom Trroublle brreatthiing
Haviing bad drreams

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14. In the past few weeks, in which of these circumstances have you had
trouble staying awake, in? *

Mark only one oval per row.

Once in Most of
Never Always
a the
while
time
IIn a cllass att schooll

Whiille compllettiing homeworrk Whiille worrkiing orr sttudyiing

Whiille rreadiing orr wrriittiing sometthiing
Durriing a ttestt Wattchiing TV Pllayiing games

15. In the past few weeks, have you missed school on any day due to feeling sleepy
or not waking up on time? *

Mark only one oval.

Ye

No

16. When do you feel the most energetic in the day? *

17. How satisfied were you with your school performance recently? *

Mark only one oval.

1 2 3 4 5

Very unsatisfied Completely satisfied

Thank you for spending time to fill this survey. Hope you will be safe and healthy during this difficult time
SLEEP
DEPRIVATION

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