Sleep Health
This questionnaire is not intended to replace professional diagnosis. Adapted from: SATED - Daniel J. Buysse, MD
In the last 15 days:
1. Are you satisfied with your sleep?
Rarely / Never
Sometimes
Usually / Always
2. Do you stay awake all day without dozing?
Rarely / Never
Sometimes
Usually / Always
3. Are you asleep between 2:00am and 4:00am?
Rarely / Never
Sometimes
Usually / Always
4. Do you spend less than 30 minutes awake at night?
(This includes the time it take to fall asleep and awakenings from sleep)
Rarely / Never
Sometimes
Usually / Always
5. Do you sleep between 7-8 hours everyday?
Rarely / Never
Sometimes
Usually / Always
Stress Health
This questionnaire is not intended to replace professional diagnosis. Adapted from: Perceived Stress Scale - Sheldon Cohen
In the last 15 days, how often have you:
1. Been upset because of something that happened unexpectedly?
Never
Almost Never
Sometimes
Fairly Often
Very Often
2. Felt that you were unable to control the important things in your life?
Never
Almost Never
Sometimes
Fairly Often
Very Often
3. Felt nervous and stressed?
Never
Almost Never
Sometimes
Fairly Often
Very Often
4. Felt unsure about your ability to handle your personal problems?
Never
Almost Never
Sometimes
Fairly Often
Very Often
5. Felt that things weren’t going your way?
Never
Almost Never
Sometimes
Fairly Often
Very Often
6. Found that you could not cope with all the things that you had to do?
Never
Almost Never
Sometimes
Fairly Often
Very Often
7. Been unable to control irritations in your life?
Never
Almost Never
Sometimes
Fairly Often
Very Often
8. Felt that you weren’t on top of things?
Never
Almost Never
Sometimes
Fairly Often
Very Often
9. Been angered because of things that were outside of your control?
Never
Almost Never
Sometimes
Fairly Often
Very Often
10. Felt difficulties were piling up so high that you could not overcome them?
Never
Almost Never
Sometimes
Fairly Often
Very Often
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