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Gender?
 
Male
 
Female
 
 
 
Age?
 
10-15
 
15-20
 
over 20
 
 
 
When do you go to sleep during the week usually?
 
21 or earlier
 
22
 
23
 
24 or later
 
 
 
How many hours do you usually sleep at nights?
 
Under 5
 
5-6
 
6-7
 
7-8
 
8-9
 
Over 9
 
 
 
When do you go to sleep usually at weekends?
 
21 or earlier
 
22
 
23
 
24 or later
 
 
 
How often do you have problems with sleeping?
 
Daily
 
Weekly
 
Monthly
 
Sometimes
 
Rarely
 
Never
 
 
 
What kind of problems do you have then?
 
Difficulties to fall asleep
 
Awakenings during the night
 
Nightmares
 
Difficulties to wake up in the mornings
 
Don't fall asleep anymore if you wake up during the night
 
Other
 

 
 
 
Have you ever needed any kind of medication for sleeping problems?
 
Yes
 
No
 
 
 
Do you have to use energy drinks or coffee to stay awake for example at school or at work?
 
Yes, both
 
Yes, coffee
 
Yes, energy drinks
 
Neither
 
Yes, I use them but not for that purpose
 
 
 
How often do you feel tired for example at school or at work?
 
Daily
 
Weekly
 
Sometimes
 
Rarely
 
Never
 
Other