Sleep Survey
Your Name (Optional):
Hometown:
State:
Alabama (AL)
Alaska (AK)
Arizona (AZ)
Arkansas (AR)
California (CA)
Colorado (CO)
Connecticut (CT)
Delaware (DE)
District Of Columbia (DC)
Florida (FL)
Georgia (GA)
Hawaii (HI)
Idaho (ID)
Illinois (IL)
Indiana (IN)
Iowa (IA)
Kansas (KS)
Kentucky (KY)
Louisiana (LA)
Maine (ME)
Maryland (MD)
Massachusetts (MA)
Michigan (MI)
Minnesota (MN)
Mississippi (MS)
Missouri (MO)
Montana (MT)
Nebraska (NE)
Nevada (NV)
New Hampshire (NH)
New Jersey (NJ)
New Mexico (NM)
New York (NY)
North Carolina (NC)
North Dakota (ND)
Ohio (OH)
Oklahoma (OK)
Oregon (OR)
Pennsylvania (PA)
Rhode Island (RI)
South Carolina (SC)
South Dakota (SD)
Tennessee (TN)
Texas (TX)
Utah (UT)
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Select your age:
18
19
20
21+
How many hours do you sleep per night?
Less than 5
6
7
8
9+
What usually keeps you up at night?
Assignments/Tests
Social Media
Insomnia
Stress
Medication
Watching shows/movies
How does this affect your well-being?
Increased Anxiety
Poor Concentration
Mood Swings
Dizziness
No effect
Additional Comments:
