Survey Templates School Surveys School Sleep Habits Survey Questions + Sample Questionnaire Template

School Sleep Habits Survey Questions + Sample Questionnaire Template

The school sleep habits survey questions help collect sleeping habits data from students. Map students’ general conduct and behavior to sleeping habits sleep patterns and sleeplessness, especially on weeknights. This sample survey template helps collect demographic information as well as information about student’s habits that impact their total sleep time. Use the sample questionnaire to educate children about the science of sleep schedule regularity, better sleeping habits, depressive mood, behavioral issues, and daytime sleepiness to positively impact their performance at school.

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What time do you usually go to bed on a school night?

Before 9 PM

Between 9 PM - 10 PM

Between 10 PM - 11 PM

Between 11 PM and midnight

Between 12:00 AM and 2 AM

2 AM or later

What is the reason you go to bed at this time on a school day?

Parents have set a time

I have set my time

I finish studying

I finish homework

I have to wake up early for school

I have to wake up early for sports or some other activity

I feel sleepy

The TV show I watch ends at that time

I am not allowed to use the internet past this time

Other

How many times in a week do you stay past your bedtime on a school night?

Once a school week

2-3 times a school week

4 or more times a school week

How long does it take you to fall asleep on a school night?

I fall asleep immediately

I take about 10 mins to fall asleep

I take 10-20 mins to fall asleep

I take 20+ mins to fall asleep

Which of these problems have you had with your sleep? Select all that apply:

Difficulty sleeping

Waking up in the middle of the night

Waking up in the middle of the night and can’t fall back to sleep

Difficulty waking up

Feel unrested on waking up

None of the above

When you wake up in the morning, what is the reason due to which you wake up?

Alarm

Any noise wakes me

Parents or pets wake me

I have to go to the bathroom

It’s now a habit

Other

Do you have any chronic illness or other health problems?

Yes

If you struggle to sleep, please state your agreement with the following statements that are causing you to sleep less:

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Not completing homework	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Stress of a home assignment	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Relationship problems	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Watching TV before sleeping	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Excessive use of phone/internet before sleeping	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Lack of physical activity	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Waking up to go to the bathroom	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Sounds from outside the room	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Sounds from inside the room	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Temperature in the room	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Trouble breathing	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

Having bad dreams	Strongly disagree	Disagree	Neutral	Agree	Strongly agree

In the past few weeks, in which of these circumstances have you had trouble staying awake, in?

	Never	Once in a while	About half the time	Most of the time	Always
Commuting to school	Never	Once in a while	About half the time	Most of the time	Always

In a class at school	Never	Once in a while	About half the time	Most of the time	Always

While completing homework	Never	Once in a while	About half the time	Most of the time	Always

During detention	Never	Once in a while	About half the time	Most of the time	Always

While reading or writing something	Never	Once in a while	About half the time	Most of the time	Always

During a test	Never	Once in a while	About half the time	Most of the time	Always

Watching TV	Never	Once in a while	About half the time	Most of the time	Always

Playing video games	Never	Once in a while	About half the time	Most of the time	Always

During a project	Never	Once in a while	About half the time	Most of the time	Always

During a field-trip	Never	Once in a while	About half the time	Most of the time	Always

In the past few weeks, have you missed school on any day due to feeling sleepy or not waking up on time?

Yes

If it were up to you, what time would be the ideal time for you for school to start:

7:30 AM

8:00 AM

8:30 AM

9:00 AM

9:30 AM

10:00 AM

10:30 AM

11:00 AM or later

If you weren’t engaged in any sports activity at school, would you go to bed:

Earlier than usual

Later than usual

The same

When do you feel the most energetic in the day?

8:00 AM - 10:00 AM

10:00 AM - 1:00 PM

1:00 PM - 3:00 PM

3:00 PM - 6:30 PM

6:30 PM or later

What is your age?

8 or below

10-12

13-14

15-16

17+

Your grades in school are mostly:

A’s

A’s and B’s

B’s

B’s and C’s

C’s

C’s and D’s

D’s

D’s and F’s

F’s

Is there any other feedback you would like to provide?

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Top Four reasons to use this free school sleep habits survey template

Here’s why you must use these questions in your survey.
1. Understand sleep habits: Behavior, grades, mood, and habits are directly related to sleep habits. Understand student sleeping habits to address these concerns.
2. Improve student performance: Guage the sleep schedules of the students and take measures to create awareness among students about the hazards of a vague sleep schedule.
3. Find shortcomings of the system: Sometimes, students are overworked to a level that they need to give up sleep to complete assignments and other personal tasks. Use this survey to address and fix such shortcomings.
4. Address student problems: Sleep is deprived not only due to academic reasons but also due to personal reasons. Find out what really stresses students and help them overcome their stress to improve their sleep schedules.

School Sleep Habits Survey Questions + Sample Questionnaire Template

Top Four reasons to use this free school sleep habits survey template

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