Sleep Well Solution
Sleep Well Quiz
Take this 30 second quiz by selecting one of the options below....
"Your life is a reflection of how you sleep, and how you sleep is a reflection of your life."
-Dr. Rafael Pelayo
What time do you go to sleep?
Before 9pm
Between 9pm & midnight
Midnight to 3am
After 3am
How many hours do you sleep a night?
Less than 6
6-8
More than 8
On average how many minutes does it take to fall asleep?
Less than 10
10-30
More than 30 minutes
How deeply do you sleep?
Very deeply, it’s rare I wake up
I wake up sometimes for various reasons
Not deep at all, I regularly wake up
What do you normally do the hour before you go to sleep? (Select One)
Watch TV
On Internet/Computer
Eat
Exercise
Work
Drink Alcohol/coffee/tea or any other stimulants
Light, Relaxing Reading
Heavy, Stressful Reading
Meditate/pray
Yoga
Do you take sleep pharmaceuticals to help you sleep?
Yes
No
My room when I fall asleep has...
Lights on
TV On
Some ambient lighting
No light, is pitch black
Do you have trouble sleeping?
Always
Sometimes
Never
I exercise...
Daily
Moderately
Never
How do you normally feel the following day?
Sleepy, not rested at all
Somewhat rested, I burn out in the middle of the day.
Rested and ready to go
Please select an option
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