Section 1: Sleep Environment

1.1 How would you describe the temperature in your bedroom? *

It feels too warm, I often sweat or kick off covers

It's sometimes too warm or too cold

It feels cool and consistently comfortable

sleep_env_temp

1.2 How dark is your bedroom during the night? *

There are noticeable light sources (streetlights, device LEDs)

I use a weak night light or light occasionally enters

It is completely dark with no light source interference

sleep_env_light

1.3 What is the typical noise level in your sleeping area? *

I am frequently disturbed by loud or unpredictable noises

There is constant background noise (fan, AC, white noise)

It is very quiet, I rarely hear distracting sounds

sleep_env_noise

1.4 How comfortable are your bed and pillow? *

I often feel uncomfortable and toss/turn throughout the night

They are okay, but I sometimes wake up with minor stiffness/pain

They are very comfortable and help me relax quickly

sleep_env_bed

Section 2: Stress and Evening Routine

2.1 How often do you use electronic screens in the hour before bed? *

Yes, I'm usually on a screen within 30 minutes of sleep

Occasionally, but I use night-mode or blue light filters

No, I put devices away at least one hour before bed

sleep_routine_screen

2.2 After lying down, how long does it usually take you to "turn off your thoughts" and fall asleep? *

More than 45 minutes

20 - 45 minutes

15 minutes or less

sr_stress_latency

2.3 What is your typical activity level in the two hours before sleep?

Vigorous exercise or mentally stressful work

Light chores or a calm walk

Meditation, reading, or gentle stretching

2.4 Do you have a fixed, consistent routine to wind down before bed?

No, my pre-sleep activities are inconsistent

I have a simple routine, but it's often interrupted

I have a dedicated, relaxing routine that I adhere to daily Export to Sheets

Evening Routine – Routine Consistency

Section 3: Health and Heart-Related Factors

3.1 Has a partner/family member ever mentioned loud snoring or gasping/choking during your sleep?

Yes, frequently or it's a known issue

Occasionally, but mostly light snoring

No, or only very soft snoring

Health Factor – Snoring/Apnea

3.2 How often do you feel an uncomfortable urge to move your legs while trying to fall asleep?

Almost every night

A few times per week

Rarely or never

Health Factor – Restless Legs

3.3 How often do you wake up during the night to use the restroom or because you are thirsty?

2 or more times per night

Once per night

Rarely or never

Health Factor – Nocturia/Thirst

3.4 Do you experience heartburn or acid reflux that affects your ability to sleep comfortably?

Several times per week

A few times per month

Rarely or never

Health Factor – Reflux Symptoms

Section 4: Lifestyle and Circadian Rhythm Disruption

4.1 What is the difference between your weekday and weekend wake-up/bedtimes? *

More than 2 hours difference (Severe "social jetlag")

1 to 2 hours difference

Less than 1 hour difference

Lifestyle – Timing Consistency

4.2 Do you regularly consume caffeine after 2 PM?

Yes, often consuming it after 4 PM

Occasionally, but usually finishing before 3 PM

Never, I only consume it in the morning

Lifestyle – Late Caffeine Intake

4.3 How consistently do you expose yourself to natural outdoor light in the morning?

Rarely, or I stay indoors for a long time after waking

Sometimes, but only for a few minutes

Every morning, I aim for 10-30 minutes of natural light exposure

Lifestyle – Morning Light Exposure

4.4 How does alcohol consumption impact your sleep?

I often drink close to bedtime to help me fall asleep, but wake up tired

I consume alcohol occasionally, but avoid it within 3 hours of sleep

I rarely or never consume alcohol

Lifestyle – Alcohol Impact

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