THE IMPACT OF SLEEP DEPRIVATION ON ACADEMIC PERFORMANCE

Name(Optional):_____________________________ Grade Level:________

Sex:____ Age:_____
Directions: To indicate your level of agreement or disagreement with each item in the survey, tick
the box located on the right side of each statement. There are no right or incorrect responses. You
will remain anonymous and your responses will be treated with the utmost confidentiality.

Scale: 4 - Always 3 - Often 2 - Sometimes 1 - Never

QUESTIONS 4 3 2 1
Always Often Sometimes Never

1. Does sleep deprivation always

negatively affect your concentration
during academic activities?
2. Do you find yourself unable to
remember study materials due to lack of
sleep?
3. Does lack of sleep cause you to
perform poorly on tests and assignments?

4. Is your ability to think critically and

solve problems affected by sleep
deprivation?
5. Do you struggle with maintaining focus
in class due to sleep deprivation?

6. Does lack of sleep lead to missing

deadlines for academic tasks?

7. Do you skip classes because you are

too tired from lack of sleep?

8. Is you motivation to participate in

academic activities diminished by lack of
sleep?
9. Do you find it difficult to understand
new concepts when you are sleep
deprived?
10. Does sleep deprivation cause you to
feel less engaged in your academic work?