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SLEEPWELL

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Sleep Quality Factor
S.No
Questions to determine scores
A
B
C
01
How many hours do you usually sleep during the night ?

6 hours

7- 8 hours or more

Less than 6 hours

02
Do you watch TV or use a cellphone or a laptop within 1/2 an hour of going to bed?

Sometimes

No

Yes

03
How long do you take to drift into sleep, once you are in bed?

Immediately

10-15 minutes

20- 40 minutes or longer

04
Do you regularly use sleeping pills/ alcohol to help you sleep?

Sometimes

No

Yes

05
Is your bedroom dark when you go to sleep?

Moderate

Yes

No

06
Is your bedroom noisy?

Sometimes

No

Yes

07
Do you wake up in the middle of night and have difficulty in falling asleep ?

Sometimes

No

Yes

08
Do you snore regularly, which is loud & disturbs others?

Sometimes

No

Yes

09
Are you tired/drowsy on waking up & during the day?

Sometimes

No

Yes

10
Do you feel your mattress is comfortable ?

May be

Yes

No

11
Do you wake up without the use of an alarm clock?

Yes

Always

No