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1.What is your gender ?
 
Male
 
female
 
 
 
2.How old are you ?
 
13-14
 
15-16
 
17-18
 
Other
 
 
 
 
3.How many hour do you sleep per night ?
 
4-5
 
5-6
 
6-7
 
7-8
 
more than 8
 
 
 
4.What do you do at night/ make you sleep late ?(Can choose more than one)
 
Telephone
 
Playing games/ social network
 
Watching TV
 
Reading Books
 
Other
 

 
 
 
5.Do you have any mental problem when you lack of sleep ?
 
Angry
 
Unconscious
 
Annoying
 
Happy
 
Other
 
 
 
 
6.Does lack of sleep affect your grades ?
 
Yes
 
No
 
 
 
7.If you are lack of sleep, do you have any health problem ?
 
Cold
 
Headache
 
Stomachache
 
No problem
 
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