Form cover

Page 1 of 4

Sleep Health Questionnaire

Hi, we're on a mission to help everyone have a good night's sleep. We've got a solution to make it happen and need your help. Answer the questions below about the quality of your sleep and your interest to improve your sleep quality. Sweet dreams, Team Tenang (Ash, Jess, Kai) https://tenang.app

In the past 7 nights, I have good quality sleep

*

1

2

3

4

5

Strongly disagreeStrongly agree

In the past 7 nights, I snore

*

1

2

3

4

5

Strongly disagreeStrongly agree

In the past 7 nights, I fall asleep easily

*

1

2

3

4

5

Strongly disagreeStrongly agree

In the past 7 nights, I gasp for air in my sleep

*

1

2

3

4

5

Strongly disagreeStrongly agree

In the past 7 nights, I wake up with dry throat

*

1

2

3

4

5

Strongly disagreeStrongly agree

I want to improve my quality of sleep

*

1

2

3

4

5

Strongly disagreeStrongly agree

I have taken a sleep test before

*

A

Yes

B

No