Sleep Quality and Habits Survey

Sleep Quality and Habits Survey — Form Fields

This surveys template includes 7 fields. Assess sleep quality, bedtime habits, and factors affecting restorative sleep. Free to customize and use on ZenBuild.

• Average Hours of Sleep Per Night (number, required)
• Sleep Quality (rating, required)
• Typical Bedtime (dropdown selection, required) — options: Before 9 PM, 9-10 PM, 10-11 PM, 11 PM-12 AM, After Midnight
• Wake Time (dropdown selection, required) — options: Before 5 AM, 5-6 AM, 6-7 AM, 7-8 AM, After 8 AM
• Factors Disrupting Sleep (checkboxes, optional) — options: Stress/Anxiety, Noise, Temperature, Screen Use, Caffeine, Partner/Pet, Sleep Apnea, Chronic Pain
• Sleep Aids Used (checkboxes, optional) — options: Melatonin, Prescription Sleep Aids, White Noise, Blackout Curtains, Meditation App, None
• Do You Feel Rested Most Mornings? (multiple choice, required) — options: Yes, Sometimes, Rarely, Never