12 February 2024
Questionnaire
1. Do you go to bed early every night and wake up early in the
morning?
Yes
No
Sometimes
2. How many hours do you sleep on an average night?
Less than 8 hours
More than 8 hours
Depends On sleep quality
3. Do you have difficulty falling asleep once in bed?
Yes
No
Sometimes
4. How many times do you wake up each night?
Once
Many times
Never
5. Do you feel refreshed upon waking in the morning?
Yes
No
Sometimes
6. How often do you feel sleepy during the day?
More often
Less often
Depends on tiredness level
7. What makes you feel sleepy during a day?
Insomnia
Hypersomnia
Medications
8. Do you have any kind stress/ depression problem?
Yes
No
9. What kind of stress do you have?
Academic stress
Personal problems
Socioeconomic stress
2
10. If yes, then how you relieve Your stress?
With the help of exercises
With the help of medications
Any other source
11. Do you have any kind of sleeping disorder?
Yes
No
Don’t know
12. Have you ever take medications for better sleep quality?
Yes
No
Often
13. If yes, then what kind of medications you take?
Benzodiazepine’s
Barbiturates
Any other class of sleeping pills
14. How frequently you take medication?
Daily
Weekly
Occasionally
3
15. what kind of minor symptoms you are facing while using
medications?
Bad or vivid dreams
Withdrawals/ nightmares
Severe headaches and heart burn
Others
16. What kind of major symptoms you are facing while using
medications?
Memory problems
Cardiovascular problems
Brain disorders
Others
17. How you take sleeping medications?
• By personal choice/( OTC)
• By physician’s order
• On friend’s/ relative’s suggestion
18. Have you ever meet any counselor or physician for stress
management or medications consultation?
• Yes
• No
• Once/ twice
4
19. Have to ever tried to get rid of medications by finding new
ways to improve sleep quality and normalize stressful
condition?
Yes
No
Once/ twice
20. Have you ever tried of doing exercises or any physical
activity to relieve stress?
• Yes
• No
• Sometimes
21. If yes, then have you ever feel any change in your life style?
Yes
No
22. Can you manage your time for doing exercise/ physical
activity?
• Yes
• No
• May be
23. Do you think your day will be much better by doing regular
exercise?
• Yes
5
• No
• May be
24. Does exercise help you get over a stress ?
Yes
No
Sometimes
25. Do you ever fall sick due to stress?
Yes
No
Often
26. If I give you one choice what would you like to prefer?
Healthy lifestyle with exercise/ physical activity
Lifestyle changes with the help of medications.
