SURVEY QUESTIONNAIRE

Name (optional):

Female ( ) Male ( )

Direction: Read the question carefully and then put a check (/) in the box.

YES NO

1. Does being sleep deprive affect your

performance in school?

2. Have you experience being sleep

deprived?

3. Does sleep deprivation affect your

grades?

4. Does sleep deprivation affects your time

in bonding with friend, family etc.?

5. Does sleep deprivation affects your

grades in school?

6. Do you drink coffee or energy drinks if

you are sleep deprived?

7. Do you sleep in class when you are

sleep deprived?

8. Do you always experience lack of

sleep?

9. Do you think that school works or

activities in school is the reason why you
are lacking of sleep?
10. Do you feel some negative moods
when you lack of sleep?