ANSWER IN MORNING AFTER WAKING FOR THE DAY

At what time did you

Approximately how

Overall about how

At what time did you

In general how did you

first go to bed

long did it take you to

many hours did

wake up (for the last

feel when you woke up?

last night?

fall asleep?

you sleep?

Time) this morning?

 

Day

 

 

 

 

□ Very refreshed

1

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

2

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

3

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

4

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

5

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

6

□ Somewhat refreshed

 

□ Fatigued

Day

 

 

 

 

□ Very refreshed

7

□ Somewhat refreshed

 

□ Fatigued