Basic Health Habit No.1: Sleep Part Two

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Sleep Hygiene Questionnaire

Sleep hygiene means the control of all behavioural and environmental factors that precede and may aid or interfere with the quality of your sleep. 

Sleep is a Basic Health Habit.

Please visit:

Basic Health Habit No.1:

Sleep - Part One

Sleep Hygiene Questionnaire

(10 Questions, 1-5 minutes) 

1. In your experience, a typical night consists of:   

• sleeping soundly the entire night
• sleeping soundly with one or two interruptions
• sleeping lightly after interruptions
• unable to fall back to sleep after interruptions
• sleeping 7-8 hours
• sleeping less than 7 hours on a regular basis 

2. Do you have difficulty falling to sleep at night?

• yes
• some
• no 

3. How do you typically feel during waking hours?

• I feel energetic and wide-awake all day
• I feel well rested all day
• I feel tired all day
• I feel tired only in the morning
• I feel tired in the afternoon

4. Do you go to bed and wake up at the same time every night?

• yes, I go to bed and wake up at approximately the same time every night
• no, I go to bed and wake up at approximately the same time on working days but different times on days off work
• no, every night is different

5. You have an important decision to make that will affect your life and it will require careful consideration. When are you most likely to think about it?

• in bed before going to sleep
• in bed after waking up
• in the shower
• during my free time
• in the middle of my busy work day
• during exercise
• at meal time
• at a specific time devoted to examining the pros and cons

6. You have had a stressful week. You have been going to bed late, sleeping poorly and getting up early every day. You would like to get home and go to bed early but you have an invitation to go out. What do you do?

• apologize and decline the invitation
• accept the invitation- you can catch up on sleep another night
• accept the invitation because you feel obliged, but hate yourself for not listening to your body's cries for rest 
• accept the invitation, you feel like you can keep this pace forever 

7. Do you spend time in nature?

• yes
• occasionally
• no

8. You have been having trouble getting to sleep and staying asleep for the past few nights. What do you do?

• call the doctor for a prescription
• buy over-the-counter sleeping pills
• try a natural remedy
• make an appointment at a sleep clinic
• relaxation methods
• lie awake at night and suffer
• start using the sleepless nights for productive pursuits, hoping that the sleeplessness will end 

 9. What is your bedtime routine?

10. List the details of your bedroom

Bonus Question
11. Evaluate your health habits using the 13 Basic Health Habits.

This questionnaire is helpful in identifying the quality of your sleep habits.

Part Three:

Sleep Aids For a Restful and Rejuvenating Sleep

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