Sleep Survey
1. Age: Choose One Less than 2 yrs 3 - 5 yrs 6 - 12 yrs 13 - 15 16 - 19 yrs 20 - 29 yrs 30 - 59 yrs Over 60 yrs
2. Gender: Male Female
3. Country: Choose One Argentina Australia Belgium Canada Finland France Germany Greece Hong Kong Hungary India Italy Malaysia Mexico Netherlands New Zealand Norway Peru Philippines Poland Russia Singapore Spain Sweden Switzerland Taiwan Thailand United Kingdom USA
4. How many hours of sleep each night do you think most people your age need? Choose one Less than 4 hrs 4-5 hrs 5-6 hrs 6-7 hrs 7-8 hrs 8-9 hrs 9-10 hrs 10-11 hrs 11-12 hrs More than 12 hrs
5. How many hours do you think most people your age actually sleep each night? Choose one Less than 4 hrs 4 hrs 5 hrs 6 hrs 7 hrs 8 hrs 9 hrs 10 hrs 11 hrs 12 hrs More than 12 hrs
6. How many hours do you sleep an average week night? Choose one Less than 4 hrs 4 hrs 5 hrs 6 hrs 7 hrs 8 hrs 9 hrs 10 hrs 11 hrs 12 hrs More than 12 hrs
7. How many hours do you sleep on an average night on the weekend? Choose one Less than 4 hrs 4 hrs 5 hrs 6 hrs 7 hrs 8 hrs 9 hrs 10 hrs 11 hrs 12 hrs More than 12 hrs
8. Do you usually work or go to school on a night or day shift? Choose one Night Day N/A
9. Have you had any of the following troubles with sleep? (Check all that apply.)