TOOL

A. Screen Time

Statement: On a typical day, how much time do you spend…

Questions 1-2 2-4 4-6 6-8 8 hours

hours hours hours hours or
higher

1. Studying

(studying, watching video classes, reading,

doing research, or school work on a
computer, television, tablet, smartphone, or
other electronic devices?)

2. Watching Videos

(watching TV shows, movies, soap operas,

news, sports, programs, or other videos on a
computer, television, tablet, smartphone, or
other electronic devices?)

3. Playing Video Games

(Playing video games on a games console,

computer, television, tablet, smartphone, or
other electronic devices?)

4. Using social media/chat applications

(using social media like Facebook, Instagram,

Twitter, Snapchat, or chat applications like
WhatsApp, Telegram, Messenger on a
computer, television, tablet, smartphone, or
other electronic devices?)

B. Sleep Quality Scale (SQS)

The following survey is to know the quality of sleep you had for the last month. Read the
questions and check the closest answer.

Examples
 Rarely: None or 1-3 times a month
Sometimes: 1-2 times a week
Often: 3-5 times a week
Almost Always: 6-7 times a week

FACTORS

1. Daytime Dysfunction

Rarely Sometimes Often Almost Always

1. Poor Sleep makes it hard for me to

think.

2. Poor sleep makes it hard to concentrate

3. Poor sleep makes me make mistakes at

work.

4. Poor sleep makes me irritated

5. Poor sleep makes me lose interest in

work or others

6. Poor sleep makes me easily tired

7. Sleepiness interferes with my daily life

8. Poor sleep makes my life painful

9. Poor sleep makes me lose desire in all

things.

10. Poor sleep makes me forget things more

easily

11. Poor sleep gives me a headache

12. Poor sleep makes me lose my appetite

2. Restoration after sleep

Rarely Sometimes Often Almost Always

1. My fatigue is relieved after sleep

2. I feel vigorous after sleep

3. I have a clear head after sleep

4. I feel refreshed after sleep

3. Difficulty in Falling asleep

Rarely Sometimes Often Almost Always

1. I have difficulty getting back to sleep

once I wake up in the middle of the
night.

2. I never go back to sleep after awakening

during sleep

3. I have difficulty falling asleep

4. I toss and turn

4. Difficulty in getting up

Rarely Sometimes Often Almost Always

1. I would like to sleep more after waking

up

2. I have difficulty getting out of bed

3. I feel unlikely to sleep after sleep.

5. Satisfaction with sleep

Rarely Sometimes Often Almost Always

1. I am satisfied with my sleep

2. I fall into a deep sleep

3. My sleep hours are enough

6. Difficulty in maintaining sleep

Rarely Sometimes Often Almost Always

1. I wake up easily because of the noise.

2. I wake up while sleeping