How Well Do You Sleep At Night?
Do you often wake up in the middle of the night?
Yes, often
Sometimes
Rarely
How tired do you feel when you wake up?
Very
Quite tired
Not so tired
What color is your room?
Blue, green, yellow
Pink, orange, pastel, white
Red, black, other
How often do you exercise?
Often
Sometimes
Rarely
Do you have headaches often?
YES
Sometimes
Not really
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