Are you dissatisfied with your sleep?
Do you need an alarm clock to wake up in the morning?
Do you feel well rested when you wake up in the morning?
Do you feel that you are functioning worse during the day?
Do you regularly fall asleep in the evening even before going to bed?
Are you having trouble falling asleep?
Do you frequently wake up at night?
Are you having trouble waking up in the morning?
Are you wakening up too early in the morning?
Do you have a fixed sleeping schedule (weekdays and weekends)?
Do you like to snooze in the morning?
Do you ever take a nap during the day?
Do you regularly work a night shift?
Do you ever suffer from restless legs?
Do you snore loudly while sleeping?
Do you ever feel suffocating at night?
Does your breath ever stop while you sleep?
Do you regularly have to get out of bed 2 or more times a night to urinate?
Are you quite stressed during the day?
Do you have a lot of work to do?
Do you often have to deal with deadlines?
Do you regularly work in the evenings?
Do you regularly study in the evenings?
Do you ask a lot of yourself?
Do you use sleeping pills?
Do you enjoy going to bed?
Do you often worry in bed and stay awake as a result?
Do you suffer from tension and stress while trying to sleep?
Do you often suffer from intense dreams?
Do you take time-outs on a regular basis?
Do you use relaxation exercises on a daily basis?
Do you go outside every day?
Are you physically active for at least half an hour every day?
(for example, by walking or cycling)
Do you drink a lot of coffee or cola?
Do you usually drink an alcoholic drink in the evening?
Do you regularly use your smartphone, tablet or laptop in the evening?
How long are you already experiencing trouble sleeping?
Do you feel that you already have sufficient prior knowledge about sleep regarding:
Click the subjects you think you already know enough about, multiple answers possible...
Do you have specific sleep questions that you would like to see answered?
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I am aware that by sending this questionnaire my name, gender, position, age, e-mail address and personal data become visible to Saraja Slaapcursus. I hereby give permission that this data will be included in the administration of Saraja Coaching and processed anonymously in the upcoming seminar/workshop. With my answers, the seminar/workshop will be adapted to the issues that affect the participants. My personal data will be kept for a maximum of 3 months after the seminar/workshop, so that this data can be used in any additional request for advice from my side. No data will be shared with my employer without my express written permission. I am aware that I can find more information about the privacy of my personal data in the privacy statement of Saraja Coaching, which is linked in the footer of the website Saraja-Slaapcursus.nl.
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