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Mental health and sleep survey
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Have you been clinically diagnosed with any anxiety and/or depressive disorders?
Yes, one or more anxiety disorders
Yes, one or more depressive disorders
Yes, one or more of both depressive and anxiety disorders
No, but I feel like there is a possibility I may have one or more of the above
No and I do not think that I have any of the above
Option 6
Clear selection
On average, how many hours of sleep do you get on a given night?
1-2
3-4
5-6
7-8
9-10
10+
Clear selection
On average, how long does it take you to fall asleep?
Less than 10 minutes
10-20 minutes
20-30
30-1 hour
1-2 hours
2+ hours
Clear selection
Do you ever feel under or unrested despite having had 8 or more hours of sleep?
never
rarely
sometimes
semi often
often
Clear selection
When do you go to bed and when do you wake up? (Free response: give us a range, Ex. 11-12pm until 8-9am)
Your answer
Do you supplement missed sleep during daytime hours?
No, I just sleep at night
The occasional 20-45 min. power nap
Daily 20-45 min. power nap
Occasional 1.5-3+ hour nap
Daily 1.5-3 hour nap
Clear selection
On a scale of 1-10, (1 being not at all, 10 being heavily) how do external stressors affect your sleep quantity and quality?
1
2
3
4
5
6
7
8
9
10
Clear selection
On a scale of 1-10, (1 being not at all, 10 being heavily) how do internal stressors affect your sleep quantity and quality?
1
2
3
4
5
6
7
8
9
10
Clear selection
(Free Response) If you have experienced depression or anxiety, what triggers an episode and how long does it last? (if you can’t remember very well just use your last episode, if you have never experienced this please say so)
Your answer
(Free Response) How have mental health or sleep issues affected your overall experience and satisfaction with social and academic aspects of college life?
Your answer
How often do you think stress gets in the way of your studies?
Always - I am constantly stressed out by all assignments or pretty much anything with a due date, and I often spend more time worrying about my work than actually working on it
Often
Sometimes - I mostly just get anxious when a big exam or project deadline is approaching and this can make it hard to stay focused
Rarely - schoolwork doesn’t really stress me out too much… I kind of just do it and get it over with
Option 5
Clear selection
How often do depression/lack of motivation/etc. get in the way of your studies?
Always - It seems as if I can never find the motivation to study, do my homework, or even go to class
Often
Sometimes
Rarely
Never - I am always motivated to do my work
Clear selection
How often do you feel that stress affects your sleep habits?
Always - most nights I am too anxious to fall asleep when I intend to
Often
Sometimes
Rarely
Never - I am always able to fall asleep when I want to, regardless of how stressed I may feel
Clear selection
(Free Response) In what ways does stress affect your sleep habits? What do you worry about that keeps you up at night?
Your answer
How many days of the week do you feel sleep-deprived?
1-2 - I usually just get tired by the end of the school week
3-5 - I know I don’t get enough sleep on most school nights
6-7 - I have trouble sleeping even on weekends
Clear selection
(Free Response) Have you been able to identify what aspects of college make you the most anxious? If so, what are they? Have you discovered any coping mechanisms to deal with them? If not, have you considered visiting the WWU Counseling Center?
Your answer
When you need help with a class, how often do you go to the tutoring center, your professor’s office hours, etc. to get help?
Always
Often
Sometimes
Rarely - I’m too nervous to ask for help when I need it
Clear selection
How often do you skip class due to stress?
Often - I often stay away from my big lecture classes because it’s difficult for me to handle being around that many people
Sometimes
Rarely - I only skip when I get really sick
Never
Clear selection
How often do you stay up later than you would like to because of school work?
Every school night - I either procrastinate or I spend too much time on my work
Some nights
School work doesn’t really affect my sleep schedule
Clear selection
In general, do you get stressed about having to work with other students in classes?
Yes, partner and/or group projects are difficult for me for various reasons
No, I’m a pretty social person so it’s chill
Clear selection
When you don’t get enough sleep, do you notice that you tend to feel more anxious during the day?
Yes
No
Sometimes
Clear selection
When you don’t get enough sleep, do you notice that you tend to feel more depressed?
Yes
No
sometimes
Clear selection
When you don’t get enough sleep do you find it more difficult to focus and learn in class?
Yes
No
sometimes
Clear selection
When you don’t get enough sleep do you find it more difficult to focus and learn in class?
Yes
No
Option 3
Clear selection
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