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Survey*

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First Name

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Last Name

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Age

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Gender

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How many children

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Email*

How is your sleep?*

Since completing the 30 Day Sleep Better Challenge, do you now consider that you have trouble falling asleep?*

Yes
No

Since completing the 30 Day Sleep Better Challenge, do you now consider that you have trouble staying asleep?*

Yes
No

Considering the last 30 days, what level of improvement have you experienced in your overall wellbeing? (1 being none, 10 being absolutely fantastic).*

Thinking about the overall 30 Day Sleep Better Challenge, how easy was it to follow your programme? (1 being really quite challenging, 10 being super easy).*

What level of improvement have you experienced in your sleep?*

Are you now sleeping through the night?*

Yes
Mostly
Sometimes
Never

How many nights per week do you wake up in the night?*

How many times do you wake up during the night?*

Please enter a number from 0 to 7.

How long are you awake for?*

Minutes

When waking during the night, did you use your SleepDrops product/s to help go back to sleep?*

Yes
No

How long does it usually take you to fall asleep, from the time you start trying to go to sleep?*

Under 20 minutes
30 minutes
40 minutes
50 minutes
60 minutes or more

Considering where you are now, how many nights per week do you have trouble falling asleep?*

Are you now prioritising your sleep?*

Yes
No

Are you woken easily by other people or noises?*

Yes
No
Sometimes

Do you toss and turn in your sleep?*

Yes
No
Sometimes

Do you snore, twitch or jerk yourself awake?*

Yes
No
Sometimes

Please select the frequency of your symptoms

Anxiety*

Headache*

Considering how you feel within 30 minutes of waking, how do you feel?*

Tired
Somewhat refreshed
Refreshed

Considering your energy throughout the day. How would you rate your energy? (1 being can’t get out of bed, 10 being “I can take on the world”)*

After participating in the SleepDrops 30 Day Sleep Better Challenge: Do you feel you are better able to manage your stress?*

Yes
No

On a scale of 1 to 10 (1 being not so much and 10 being very much) how would you rate the impact your lack of sleep is having on your sex drive*

Ability to socialize*

Family time*

Experiencing food cravings or making poor food choices*

Quality of life*

Performance at work*

Did you experience any adverse reactions to any of the recommended products?*

Loose bowel movements
Headache
Feeling groggy in morning
Over sleeping
NONE APPLY

Did you stop taking any products?*

Yes
No

Which product did you stop taking and why?*

National Sleep Foundation

Health Sleep Index Questionnaire

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National Sleep Foundation

Health Sleep Index Questionnaire

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