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Sleep and Dream Survey 7th period
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This is a survey for people in grades 7-12 about their sleep patterns and habits.
What is your age?
10-12
12-14
14-16
16-18
18-65
What time do you go to sleep?
before 10 P.M.
10-11 P.M.
11-12 P.M.
12 P.M.- 2 A.M.
2 A.M.-after
Do you ever wake up at night?
Yes
No
Are your dreams realistic or unrealistic?
Realistic
Unrealistic
Are you able to remember your dreams? Please explain.
Do you listen to music or watch TV in order to help you fall asleep? Yes or no, and if yes please explain.
What is the first thing you think of when you open your eyes?
Do you wake up after your dreams?
Yes
No
Have you ever had the famous "falling" dream? If yes, please explain.
Do your dreams ever tell you things or messages? If yes, please explain.
What is your gender?
Male
Female
Does anyone in your immediate family have a problem with sleeping, such as sleep apnea or insomnia? If yes, Please explain.
This poll was created on 2012-10-29 20:06:23 by
AdamCarlson13
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