Quantity of sleep |
What time did you usually go to bed on weekdays? |
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How long did it take to fall asleep? |
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What time did you usually go to bed on weekends? |
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What time did you usually get out of bed on weekdays? |
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What time did you usually get out of bed on weekends? |
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How many hours did you sleep every night on weekdays? |
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How many hours did you sleep every night on weekends? |
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How many hours did you get a nap on weekdays? |
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How many hours did you get a nap on weekends? |
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Sleep quality |
How many days per week do you have difficulties falling asleep? |
/7 |
How many days per week do you wake up too early? |
/7 |
How many days per week do you use Hypnotic medications (sleep aids)? |
/7 |
How many days per week do you fall asleep during the day? |
/7 |
How many days per week do you feel tired upon waking up in the morning? |
/7 |
How many days per week do you snore? |
/7 |
How many days per week do you experience mid-sleep awakenings? |
/7 |
How many days per week do you experience headaches on awakening? |
/7 |
How many days per week do you experience excessive daytime sleepiness? |
/7 |
How many days per week do you experience excessive movement during sleep? |
/7 |
Total score of sleep quality out of 70 |
/70 |
Mood |
How many days per week do you experience no energy to get things done? |
/7 |
How many days per week do you experience sadness? |
/7 |
How many days per week do you experience worry? |
/7 |
How many days per week do you experience anger? |
/7 |
How many days per week do you experience physical pain? |
/7 |
Total score of mood status out of 35 |
/35 |
Diet |
How many days per week do you eat fast food? |
/7 |
How many days per week did you eat red meat? |
/7 |
How many days per week do you eat fish/omega 3? |
/7 |
How many days per week do you eat 4–5 servings of fruits/vegetables? |
/7 |
How many days per week did you take vitamin D tablet? |
/7 |
How many days per week did you take Magnesium tablet? |
/7 |
Total Score of Diet out of 42 |
/42 |
Physical activity |
How many days per week in a normal week do you engage in at least 30-minute pre-planned physical
activity? |
/7 |
Social activity |
How many days per week did you participate in a social, cultural, or support group that you belong to? |
/7 |
Smoking behavior |
Do you smoke? |
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If yes, how many cigarettes do you smoke per day? |
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Self-rated wellness & health |
How much do you rate your wellness and health out of 10; 10 being the healthiest and 0 being the unhealthiest? |
/10 |