Sleep-Wake Cycle Questionnaire

1. When you go to bed, do you have a hard time falling asleep?

Yes No

2. Do you travel across time zones more than once a month?

Yes No

3. Do you wake up feeling unrested or in need of more sleep 3 or more times per week?

Yes No

4. Do you sleep less than 7 hours, 3 or more times per week?

Yes No

5. Are your bowel movement times inconsistent or unpredictable on a daily basis?

Yes No

6. Does your sense of hunger change when your sleep is restricted?

Yes No

7. Do you wake up between 1 am and 5 am and have a hard time falling back to sleep, 3 or more times per week?

Yes No

8. Do you tend to have a hard time staying awake in the afternoon after eating lunch?

Yes No

9. Do you do shift work that requires you to stay up late at night?

Yes No

10. Do you often have caffeine (black/green tea, coffee, cola) after 3 pm?

Yes No

11. Do you keep any mobile devices, laptop, or tablet in your bedroom whilst you sleep?

Yes No

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