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Sleep Quality Assessment

Evaluate your sleep quality, timing, and habits to identify improvement opportunities.

## đź“– The Story

Three People, Three Approaches​

Alex: The Ignorer

Alex is 29 and works in tech. He's always been a "night owl" and proudly calls himself a "5-hour sleeper."

Monday morning, 6:30 AM: Alex's alarm blares. He hits snooze three times before dragging himself out of bed after his usual 4 hours of sleep. He immediately reaches for his phone and makes coffee—his third cup comes by 10 AM. He doesn't think much of it. "This is just who I am," he tells himself.

2:00 PM: During a meeting, Alex's mind wanders. He catches himself re-reading the same email three times. He grabs an energy drink. "Just a little afternoon slump," he thinks.

11:00 PM: Still scrolling Instagram in bed. "I'll just watch one more video..." An hour later, he's finally asleep.

The pattern continues for months. Alex doesn't realize his constant irritability is linked to sleep. He doesn't connect his weight gain to the late-night snacking when he can't sleep. He doesn't see that his "afternoon slump" is his body screaming for rest. When someone suggests he has a sleep problem, he dismisses it: "I feel fine."

The wake-up call came when he nearly rear-ended someone on his commute—he'd microsleep at the wheel.

Jordan: The Worrier

Jordan is 35, recently read about sleep on social media, and now obsessively tracks everything.

Every night: Jordan straps on her sleep tracker, sets her phone to airplane mode exactly 60 minutes before her scheduled bedtime, dims lights to precisely the right level, and checks the room temperature (must be 67°F). She lies down and... can't sleep. She's thinking about her sleep score. "Will tonight be an 85 or 90?"

3:00 AM: Jordan wakes up, immediately checks her watch. "Four hours so far—not bad." But now she's calculating: "If I fall back asleep in the next 12 minutes, I'll still get 7.5 hours..." The anxiety keeps her awake for 45 more minutes.

Morning: Her tracker says "Poor sleep quality: 64." Jordan's day is ruined before it starts. She's frustrated and anxious. She Googles "how to improve deep sleep percentage" and finds seventeen conflicting articles.

The tracking has become the problem. Jordan has turned sleep into a performance sport. Her anxiety about sleep quality is now worse than the original problem. She's so focused on the metrics that she's forgotten to notice—she actually feels reasonably rested most mornings.

Her breakthrough came when her doctor said: "Stop checking the tracker at night. If you wake up feeling okay, that's your real score."

Sam: The Systematic Improver

Sam is 42, felt constantly tired, and decided to do something about it—methodically.

Week 1: Sam takes the sleep assessment honestly. Score: 58. Not great. Rather than panic, Sam reads through each section. Section D (habits) is the lowest: 8/20. "Okay, that's where I'll start."

Week 2: Sam picks ONE thing: no screens after 10 PM. It's hard. The first three nights feel impossible. By day 5, Sam finds a book and reads for 30 minutes before bed. Sleep improves slightly.

Week 5: Sam retakes the assessment. Score: 68. Better! Section D improved to 14/20. Now Section C (environment) is lowest. Sam buys blackout curtains for $40.

Week 9: Score: 76. Sam notices something: waking up doesn't feel like torture anymore. There's energy to exercise before work. The brain fog has lifted.

Week 13: Score: 83. Sam's partner comments: "You seem... happier?" Sam realizes the afternoon irritability is gone. Decision-making feels sharper. That persistent 3 PM energy crash has disappeared.

What made the difference? Sam didn't try to overhaul everything overnight. Each change was small and specific. The tracking was purposeful—retake the assessment every 4 weeks, not obsessively every night. Sam focused on the process, not perfection.

One year later: Sam's sleep score hovers between 80-87. Some weeks are better than others—life happens. But the foundation is solid. When stress hits, sleep is now protected, not sacrificed. Sam helped two friends improve their sleep using the same methodical approach.

What These Stories Teach Us​

Alex's mistake: Ignoring the problem doesn't make it go away. Sleep debt accumulates invisibly, affecting everything from cognitive function to emotional regulation to physical health. "I feel fine" often means "I don't remember what well-rested feels like."

Jordan's mistake: Measurement without purpose creates anxiety. Sleep shouldn't be stressful. The goal isn't a perfect score—it's sustainable, restorative rest that supports your life.

Sam's approach: Assess honestly, identify specific issues, change one thing at a time, measure progress periodically, and let improvement compound. This is the path that works.

The question is: which person are you right now, and which do you want to become?

🚶 Journey​

The Sleep Assessment Timeline

Understanding where you are in your sleep journey helps set realistic expectations.

Phase 1: Awareness (Week 1)​

What Happens:

  • Complete initial assessment
  • Track sleep for 7 days
  • Identify patterns and problem areas
  • Notice how sleep affects your day

Expected Feelings:

  • Eye-opening realizations
  • Overwhelm at what needs fixing
  • Curiosity about sleep data
  • Relief at understanding fatigue

Phase 2: Foundation Building (Weeks 2-4)​

What Happens:

  • Implement basic sleep hygiene
  • Establish consistent wake time
  • Create wind-down routine
  • Optimize sleep environment

Expected Changes:

  • Easier time falling asleep
  • Fewer night wakings
  • Better morning energy
  • Still some inconsistency

Phase 3: Optimization (Weeks 5-8)​

What Happens:

  • Fine-tune bedtime timing
  • Adjust environment details
  • Address remaining issues
  • Build habit resilience

Expected Improvements:

  • Consistent sleep patterns
  • Wake without alarm
  • Sustained daily energy
  • Recovery from poor nights faster

Phase 4: Maintenance (Ongoing)​

What Happens:

  • Protect sleep during stress
  • Adjust for life changes
  • Monitor with periodic reassessment
  • Help others with lessons learned

Long-term Reality:

  • Not every night is perfect
  • Life disrupts sleep sometimes
  • Good habits bounce back quickly
  • Sleep becomes automatic priority

Typical Timeline:

  • Week 1: Notice 10-20% improvement
  • Week 4: See 40-60% improvement
  • Week 8: Achieve 70-80% of potential
  • Months 3-6: Reach optimal sleep

🧠 Science​

Why Sleep Assessments Matter

The Sleep Crisis​

Current Reality:

  • 35% of adults get <7 hours of sleep
  • 50-70 million Americans have sleep disorders
  • $411 billion annual economic cost
  • Most people don't realize how sleep-deprived they are

What Sleep Does​

Physical Restoration:

  • Repairs muscle tissue and cellular damage
  • Regulates hormones (growth hormone, cortisol, leptin, ghrelin)
  • Strengthens immune system
  • Clears metabolic waste from brain

Cognitive Function:

  • Consolidates memories (moves from short to long-term)
  • Enhances learning and problem-solving
  • Improves decision-making and creativity
  • Restores attention and focus

Emotional Regulation:

  • Processes emotional experiences
  • Reduces stress and anxiety
  • Stabilizes mood
  • Increases resilience

The Cost of Poor Sleep​

After Just One Night:

  • 30% reduction in glucose metabolism
  • Cognitive impairment equivalent to 0.1% BAC
  • Increased inflammatory markers
  • Reduced emotional control

After One Week (<6 hours/night):

  • Gene expression changes (711 genes affected)
  • Insulin sensitivity decreased by 40%
  • Hunger hormones dysregulated
  • Cognitive performance like 24 hours without sleep

Chronic Sleep Deprivation:

  • 2x risk of obesity
  • 3x risk of type 2 diabetes
  • 48% increased risk of heart disease
  • Accelerated cognitive decline
  • Shortened lifespan

Why Self-Assessment Works​

Key Principle: Subjective sleep quality predicts health outcomes as well as objective measures.

What Research Shows:

  • Pittsburgh Sleep Quality Index (similar to this) correlates with polysomnography
  • Self-reported sleep satisfaction predicts mortality risk
  • Simple behavioral tracking identifies 80% of sleep issues
  • Environmental and habit factors are often more important than disorders

When Professional Assessment Needed:

  • Suspected sleep apnea (snoring, gasping)
  • Insomnia lasting >3 months
  • Restless leg syndrome
  • Score <40 despite implementing changes

📖 Instructions​

How to Take This Assessment

Time Required: 5 minutes

Before You Begin:

  • Answer based on your typical sleep over the past 2-4 weeks
  • Don't answer based on one unusually good or bad night
  • Be honest—there are no "right" answers
  • If unsure, go with your first instinct

Scoring:

  • Each question is worth 0-5 points
  • Add up your total score
  • Maximum possible: 100 points

📋 Assessment Questions​

Complete All 20 Questions

Section A: Sleep Duration & Timing (25 points)​

Q1. How many hours of sleep do you typically get per night?

  • 7-9 hours (5 points)
  • 6-7 hours (3 points)
  • 5-6 hours (1 point)
  • Less than 5 or more than 9 hours (0 points)

Q2. How consistent is your bedtime during the week?

  • Within 30 minutes of same time (5 points)
  • Within 1 hour (3 points)
  • Within 2 hours (1 point)
  • Varies widely (0 points)

Q3. How consistent is your wake time during the week?

  • Within 30 minutes of same time (5 points)
  • Within 1 hour (3 points)
  • Within 2 hours (1 point)
  • Varies widely (0 points)

Q4. How different is your weekend sleep schedule from weekdays?

  • Same as weekdays (5 points)
  • 30-60 minutes different (3 points)
  • 1-2 hours different (1 point)
  • More than 2 hours different (0 points)

Q5. What time do you typically go to bed?

  • Before 11 PM (5 points)
  • 11 PM - midnight (4 points)
  • Midnight - 1 AM (2 points)
  • After 1 AM (0 points)

Section B: Sleep Quality (30 points)​

Q6. How long does it typically take you to fall asleep?

  • Less than 15 minutes (5 points)
  • 15-30 minutes (4 points)
  • 30-45 minutes (2 points)
  • More than 45 minutes (0 points)

Q7. How often do you wake up during the night?

  • Rarely (0-1 times) (5 points)
  • Sometimes (2-3 times) (3 points)
  • Often (4+ times) (1 point)
  • Almost every hour (0 points)

Q8. When you wake at night, how long are you awake?

  • Fall back asleep quickly (<5 min) (5 points)
  • Usually <15 minutes (3 points)
  • 15-30 minutes (1 point)
  • Often 30+ minutes (0 points)

Q9. How refreshed do you feel when you wake up?

  • Well-rested and ready to go (5 points)
  • Somewhat rested, takes a bit to get going (3 points)
  • Still tired, need time (1 point)
  • Exhausted, dread getting up (0 points)

Q10. How would you rate your overall sleep quality?

  • Excellent (5 points)
  • Good (4 points)
  • Fair (2 points)
  • Poor (0 points)

Q11. How often do you remember your dreams?

  • Sometimes (healthy sign) (5 points)
  • Rarely (3 points)
  • Almost never or too frequently (1 point)
  • (This is a minor indicator) (Score 3 if unsure)

Section C: Sleep Environment (15 points)​

Q12. How dark is your bedroom when sleeping?

  • Completely dark (can't see hand) (5 points)
  • Very dark (small light sources) (3 points)
  • Some light (streetlight, electronics) (1 point)
  • Significant light exposure (0 points)

Q13. What temperature is your bedroom?

  • Cool (65-68°F / 18-20°C) (5 points)
  • Moderate (68-72°F / 20-22°C) (3 points)
  • Warm or cold (outside optimal) (1 point)
  • Uncomfortable temperature (0 points)

Q14. How quiet is your sleep environment?

  • Very quiet or consistent white noise (5 points)
  • Mostly quiet with occasional disturbance (3 points)
  • Regular disturbances (traffic, partner, etc.) (1 point)
  • Frequently disturbed (0 points)

Section D: Sleep Habits (20 points)​

Q15. Do you use screens (phone, TV, computer) in the hour before bed?

  • No, I avoid screens 1+ hour before bed (5 points)
  • Sometimes, with blue light blocking (3 points)
  • Yes, but I try to minimize (1 point)
  • Yes, regularly until sleep (0 points)

Q16. Do you consume caffeine in the afternoon/evening?

  • No caffeine after noon (5 points)
  • No caffeine after 2 PM (3 points)
  • No caffeine after 4 PM (1 point)
  • Caffeine in evening (0 points)

Q17. Do you have a consistent wind-down routine before bed?

  • Yes, consistent relaxing routine (5 points)
  • Usually have some routine (3 points)
  • Inconsistent (1 point)
  • No routine, variable activities (0 points)

Q18. How often do you eat large meals within 2 hours of bed?

  • Rarely or never (5 points)
  • Occasionally (1-2x per week) (3 points)
  • Frequently (3-4x per week) (1 point)
  • Most nights (0 points)

Section E: Daytime Indicators (10 points)​

Q19. How often do you feel sleepy during the day?

  • Rarely (5 points)
  • Occasional afternoon dip (3 points)
  • Frequently tired (1 point)
  • Constantly fighting sleepiness (0 points)

Q20. How dependent are you on caffeine to function?

  • Don't need it / enjoy it occasionally (5 points)
  • Prefer it but function without (3 points)
  • Need it to feel normal (1 point)
  • Can't function without multiple servings (0 points)

👀 Signs & Signals​

What Your Results Indicate

Score-Based Indicators​

85-100 (Excellent):

  • Physical Signs: Wake naturally without alarm, steady energy all day, quick recovery from exercise
  • Mental Signs: Sharp focus, good memory, creative problem-solving
  • Emotional Signs: Stable mood, handle stress well, positive outlook
  • What It Means: Sleep is optimized; a competitive advantage

70-84 (Good):

  • Physical Signs: Usually feel rested, occasional afternoon energy dip, normal recovery
  • Mental Signs: Generally focused with some lapses, adequate memory
  • Emotional Signs: Mostly stable mood, minor irritability when stressed
  • What It Means: Solid foundation; small optimizations can yield big gains

55-69 (Needs Attention):

  • Physical Signs: Rely on alarm, need caffeine to function, slow recovery
  • Mental Signs: Difficulty concentrating, forgetfulness, reduced productivity
  • Emotional Signs: Mood swings, increased anxiety, short temper
  • What It Means: Sleep debt accumulating; affecting daily performance

40-54 (Concerning):

  • Physical Signs: Constant fatigue, multiple caffeine servings needed, poor recovery
  • Mental Signs: Brain fog, significant memory issues, poor decisions
  • Emotional Signs: Persistent irritability, anxiety, feeling overwhelmed
  • What It Means: Chronic sleep deprivation; health consequences likely

Below 40 (Critical):

  • Physical Signs: Exhaustion, falling asleep unintentionally, compromised immune function
  • Mental Signs: Severe cognitive impairment, dangerous for driving/work
  • Emotional Signs: Depression symptoms, severe anxiety, emotional instability
  • What It Means: Medical concern; immediate intervention required

Section-Specific Signals​

Section A (Timing) Low:

  • Signals: Weekend "catch-up" sleep, social jet lag, shift work challenges
  • Indicates: Circadian rhythm disruption
  • Impact: Metabolic issues, mood instability, reduced cognitive function

Section B (Quality) Low:

  • Signals: Not refreshed despite hours in bed, frequent dreams/nightmares, partner reports snoring
  • Indicates: Sleep architecture problems or disorders
  • Impact: Missing deep sleep or REM; can indicate sleep apnea

Section C (Environment) Low:

  • Signals: Tossing and turning, temperature discomfort, awareness of external noise
  • Indicates: Fixable environmental factors preventing deep sleep
  • Impact: Fragmented sleep; easiest problems to solve

Section D (Habits) Low:

  • Signals: Mind racing at bedtime, inconsistent routines, stimulant dependence
  • Indicates: Behavioral factors undermining sleep
  • Impact: Sleep onset insomnia; self-created problems

Section E (Daytime) Low:

  • Signals: Microsleeps, caffeine dependence, afternoon crashes
  • Indicates: Sleep not restorative or insufficient duration
  • Impact: Safety risks, poor performance, health consequences

Warning Signs Requiring Medical Evaluation​

Sleep Apnea Red Flags:

  • Loud snoring with pauses
  • Gasping or choking during sleep
  • Morning headaches
  • Severe daytime sleepiness despite "adequate" sleep

Insomnia Disorder:

  • Can't fall asleep despite perfect conditions
  • Anxiety about sleep itself
  • Lasting >3 months
  • Significantly impacting life

Circadian Rhythm Disorders:

  • Can't fall asleep until very late (Delayed Phase)
  • Wake extremely early (Advanced Phase)
  • Inconsistent sleep-wake times (Non-24)

Other Concerns:

  • Restless leg syndrome (urge to move legs)
  • Sleep paralysis or hallucinations
  • Acting out dreams (REM behavior disorder)
  • Unexplained weight gain despite good diet/exercise

📊 Scoring​

Calculate Your Score

Add Up Your Points​

SectionYour ScoreMaximum
A: Duration & Timing___25
B: Sleep Quality___30
C: Environment___15
D: Sleep Habits___20
E: Daytime Indicators___10
TOTAL___100

Interpret Your Score​

ScoreCategoryWhat It Means
85-100ExcellentSleep is a strength. Maintain current practices.
70-84GoodSolid foundation with room for optimization.
55-69Needs AttentionSleep is holding you back. Prioritize improvement.
40-54ConcerningSignificant sleep issues affecting health. Take action.
Below 40CriticalSleep crisis. Make this #1 priority immediately.

Section Analysis​

Also look at individual sections:

Section ScoreMeaning
A lowTiming and duration issues—fix schedule consistency
B lowQuality issues—may need sleep environment or health check
C lowEnvironmental problems—easy fixes available
D lowHabit issues—behavior changes needed
E lowDaytime consequences—sleep isn't restorative

📸 What It Looks Like​

Example Assessment Results

Case Study 1: The Optimized Sleeper​

Profile: Sarah, 32, software engineer

Score Breakdown:

  • Section A (Timing): 23/25
  • Section B (Quality): 28/30
  • Section C (Environment): 14/15
  • Section D (Habits): 19/20
  • Section E (Daytime): 9/10
  • Total: 93/100

What This Looks Like:

Typical Day:
10:30 PM: Screens off, reading in dim light
11:00 PM: Asleep within 10 minutes
7:00 AM: Wake naturally (occasionally before alarm)
Morning: Alert and energetic, no caffeine needed until 9 AM

Weekend: Same schedule ± 30 minutes

Key Habits:

  • Blackout curtains and white noise machine
  • Bedroom at 67°F
  • No caffeine after 2 PM
  • Consistent wind-down routine

Result: Sleep is a competitive advantage; uses energy for ambitious projects

Case Study 2: The Improvable Sleeper​

Profile: James, 28, marketing manager

Score Breakdown:

  • Section A (Timing): 15/25 ⚠️
  • Section B (Quality): 22/30
  • Section C (Environment): 11/15
  • Section D (Habits): 12/20 ⚠️
  • Section E (Daytime): 6/10
  • Total: 66/100

What This Looks Like:

Typical Weeknight:
11:30 PM: Scrolling phone in bed
12:30 AM: Still trying to fall asleep
1:00 AM: Finally asleep
7:00 AM: Alarm (hits snooze 2x)
Morning: Groggy, needs 2 cups coffee

Weekend: Sleep until 10 AM to "catch up"

Problem Areas:

  • No consistent bedtime (11 PM - 2 AM range)
  • Screen time in bed
  • Weekend schedule completely different
  • Reliant on caffeine

Action Plan:

  1. Set bedtime alarm for 11 PM
  2. Phone stays in other room
  3. Limit weekend sleep shift to 1 hour
  4. Result after 4 weeks: Score improved to 78

Case Study 3: The Sleep Crisis​

Profile: Mike, 45, executive

Score Breakdown:

  • Section A (Timing): 8/25 ⚠️⚠️
  • Section B (Quality): 12/30 ⚠️⚠️
  • Section C (Environment): 5/15 ⚠️
  • Section D (Habits): 4/20 ⚠️⚠️
  • Section E (Daytime): 2/10 ⚠️⚠️
  • Total: 31/100

What This Looks Like:

Typical Day:
1:00 AM: Finally in bed after work emails
1:30 AM: Can't fall asleep (mind racing)
2:30 AM: Asleep
5:30 AM: Wake up multiple times
6:00 AM: Give up, get up
Day: 4-5 cups coffee, afternoon crash, microsleeps in meetings

Critical Issues:

  • Severe sleep deprivation (<5 hours)
  • No schedule consistency
  • Work until bedtime
  • Partner reports loud snoring

Immediate Actions:

  1. Medical evaluation (possible sleep apnea)
  2. Hard stop on work at 9 PM
  3. Sleep became #1 priority
  4. After 8 weeks + CPAP: Score improved to 64, continuing to improve

Case Study 4: The Environmental Fix​

Profile: Rachel, 26, nurse (shift work)

Score Breakdown:

  • Section A (Timing): 10/25 (shift work)
  • Section B (Quality): 18/30
  • Section C (Environment): 6/15 ⚠️⚠️
  • Section D (Habits): 15/20
  • Section E (Daytime): 5/10
  • Total: 54/100

What This Looks Like:

After Night Shift:
8:00 AM: Gets home, tries to sleep
Environment: Bright sun through curtains, street noise, too warm
9:00 AM: Still awake
10:00 AM: Finally sleeps poorly
2:00 PM: Wakes up tired

The Fix:

  • Blackout curtains ($50)
  • White noise machine ($30)
  • Sleep mask and earplugs
  • AC set to 66°F

Result: Environmental changes alone brought score to 72, despite shift work challenges

Key Patterns Across Cases​

Common Theme: Most improvement comes from fixing 2-3 specific issues, not overhauling everything.

Highest ROI Changes:

  1. Consistent wake time (even weekends)
  2. Screen-free hour before bed
  3. Cool, dark, quiet bedroom
  4. Caffeine cutoff time

Red Flags for Medical Help:

  • Score <40 despite changes
  • Snoring with breathing pauses
  • Can't stay awake during day
  • No improvement after 4-6 weeks

🎯 Next Steps Based on Score​

What to Do With Your Results

Your Sleep Is Strong​

What's Working:

  • Continue current sleep habits
  • Your sleep is a foundation for other goals
  • Focus on maintaining consistency

Optimization Opportunities:

  • Track sleep with wearable for data
  • Consider optimizing for specific goals (performance, recovery)
  • Help others with what works for you

Caution:

  • Don't sacrifice this for other goals
  • Protect sleep during stressful periods
  • Watch for drift over time
## 🔧 Common Issues by Section

Section A Issues (Timing)​

ProblemSolution
Inconsistent bedtimeSet alarm for "go to bed" time
Weekend sleep debtLimit weekend variation to 1 hour
Late bedtimeMove earlier by 15 min/week
Variable scheduleAnchor wake time first

Section B Issues (Quality)​

ProblemSolution
Long time to fall asleepWind-down routine, limit screens
Frequent wakingCheck environment, limit fluids
Not feeling refreshedMay indicate poor deep sleep
Can't fall back asleepKeep room dark, avoid clock-watching

Section C Issues (Environment)​

ProblemSolution
Too much lightBlackout curtains, sleep mask
Wrong temperatureSet thermostat to 65-68°F (18-20°C)
Noise disturbancesWhite noise machine, earplugs
Poor mattress/pillowInvest in quality (huge ROI)

Section D Issues (Habits)​

ProblemSolution
Screen time before bed1-hour digital sunset
Late caffeineNo caffeine after noon
No wind-down routineCreate 30-min routine
Late mealsFinish eating 3 hours before bed
## 🤖 For Mo

AI Coach Guidance​

Score-Based Recommendations:

Score RangePrimary Guidance
85-100"Your sleep is excellent. Let's focus on your other goals knowing this foundation is solid."
70-84"Good sleep foundation. Let's look at one or two specific areas to optimize."
55-69"Sleep needs attention. I'd recommend focusing here before tackling other goals—it'll make everything easier."
<55"Sleep is a critical priority right now. Let's make this the focus. What's your biggest sleep challenge?"

Follow-Up Questions:

  • "What does your typical evening look like in the hour before bed?"
  • "How consistent is your wake-up time day to day?"
  • "Do you feel rested when you wake up?"

Red Flags (Recommend Professional):

  • Snoring with pauses in breathing
  • Unable to stay awake during day
  • Sleep issues despite perfect habits
  • Score <40 that doesn't improve

🚀 Getting Started​

How to Begin Assessing and Improving Your Sleep

Step 1: Complete the Assessment (Now)​

Time: 5 minutes

Action:

  1. Answer all 20 questions honestly
  2. Calculate your total score
  3. Note your lowest-scoring section
  4. Don't judge yourself—just gather data

Why: You need a baseline to measure progress.

Step 2: Track for One Week (Days 1-7)​

Time: 2 minutes per day

What to Track:

  • Bedtime and wake time
  • Estimated sleep duration
  • How you felt in the morning (1-5 scale)
  • Caffeine consumption and timing
  • Screen time before bed

Tools:

  • Simple notes app or journal
  • Phone's built-in sleep tracking
  • Wearable device (optional, not required)

Why: Patterns become obvious when you track, and you often discover surprises.

Step 3: Pick ONE Thing to Fix (Week 2)​

Don't try to fix everything at once.

Choose Based on Your Lowest Score:

If Section A (Timing) is lowest:

  • → Pick a consistent wake time (even weekends)
  • → Set a "go to bed" alarm
  • → Limit weekend variation to 1 hour

If Section B (Quality) is lowest:

  • → Create a 30-minute wind-down routine
  • → Make one environmental improvement
  • → Consider sleep position or pillow

If Section C (Environment) is lowest:

  • → Make room darker (easiest: sleep mask)
  • → Adjust temperature (set thermostat to 65-68°F)
  • → Add white noise if noise is an issue

If Section D (Habits) is lowest:

  • → No screens 1 hour before bed
  • → Set caffeine cutoff time (start with 2 PM)
  • → Establish simple bedtime routine

If Section E (Daytime) is lowest:

  • → This is usually a symptom of other sections
  • → Focus on timing (Section A) first
  • → Consider medical evaluation if severe

Rule: One change only. Master it before adding more.

Step 4: Implement and Track (Weeks 2-4)​

Time: Daily consistency

Your Focus:

  • Stick to your ONE change every day
  • Keep tracking sleep metrics
  • Notice how you feel
  • Don't add more changes yet

What to Expect:

  • Week 1: Feels forced, requires conscious effort
  • Week 2: Getting easier, some good nights
  • Week 3: Becoming habit, clear improvements
  • Week 4: Feels natural, ready for next step

Common Obstacles:

ObstacleSolution
"I forget"Set phone reminders/alarms
"Weekends are hard"This is where growth happens—push through
"Not seeing results"Changes take 2-3 weeks to show full effect
"Too many things wrong"That's why you pick ONE—trust the process

Step 5: Reassess (Week 5)​

Time: 5 minutes

Action:

  1. Retake the full assessment
  2. Compare to baseline score
  3. Celebrate improvements (even small ones)
  4. Identify next lowest-scoring area

Typical Results After 4 Weeks:

  • 10-20 point improvement from ONE focused change
  • Noticeable difference in daily energy
  • Motivation to tackle next issue

Step 6: Add Second Improvement (Weeks 5-8)​

Now you can add another change.

Strategy:

  • First change should be automatic now
  • Pick next lowest-scoring section
  • Apply same focused approach
  • Keep tracking

Building Momentum:

  • Each change makes the next easier
  • Sleep improvements compound
  • You'll naturally start protecting sleep
  • Good sleep makes other wellness goals easier

Step 7: Ongoing Optimization (Month 3+)​

Sleep is now a priority.

Maintenance Mode:

  • Reassess every 2-3 months
  • Protect sleep during stressful periods
  • Adjust for life changes (travel, new job, etc.)
  • Help others with what you've learned

Long-term Mindset:

  • Sleep is not negotiable
  • Other goals depend on this foundation
  • Perfect is the enemy of good (consistency beats perfection)
  • You now have a skill for life

Quick Start Checklist​

Today:

  • Complete assessment
  • Calculate score
  • Identify lowest section

This Week:

  • Track sleep for 7 days
  • Notice patterns
  • Choose ONE improvement

Next 4 Weeks:

  • Implement chosen change daily
  • Keep tracking
  • Resist urge to fix everything at once

Week 5:

  • Reassess
  • Celebrate progress
  • Choose next improvement

Common Starting Points by Score​

85-100: You're already optimized. Consider advanced tracking or helping others.

70-84: Start with your lowest-scoring question. Usually a quick win available.

55-69: Start with Section A (timing) if low. If not, tackle environment or habits.

Below 55: Start with consistent wake time. This is foundational. Then environment. Consider medical evaluation.

Tools You Don't Need (But Can Help)​

Free/Built-in:

  • Phone sleep tracking (iPhone Health, Android Digital Wellbeing)
  • Basic notes app for tracking
  • Phone's Do Not Disturb schedule

Worth Considering ($):

  • Blackout curtains ($30-100)
  • White noise machine ($20-50)
  • Quality pillow ($50-150)
  • Sleep mask ($10-30)

Optional ($$):

  • Wearable sleep tracker ($100-400)
  • Smart thermostat ($100-250)
  • Sunrise alarm clock ($30-150)

Not Necessary:

  • Expensive mattress (useful but not first priority)
  • Sleep apps with premium subscriptions
  • Complicated sleep analysis systems

The Truth: Most improvement comes from free behavior changes, not purchases.

## 🔧 Troubleshooting

Common Sleep Assessment Problems​

"My scores vary wildly day to day"

This is actually normal—sleep quality naturally fluctuates. Here's how to handle it:

Solution:

  • Don't assess daily. The assessment is designed for your typical sleep over 2-4 weeks, not individual nights
  • Track trends, not individual data points. If you're tracking daily metrics, look at weekly averages, not single nights
  • Identify patterns behind variability. Are bad nights linked to specific triggers (alcohol, late meals, stress, exercise timing)?
  • Accept natural variation. Even optimal sleepers have occasional poor nights—it's the pattern that matters
  • Use weekly assessments max. If doing frequent check-ins, calculate weekly averages before scoring

When variability is a red flag:

  • Scores swinging 20+ points week to week with no clear cause
  • Unpredictable sleep despite consistent habits
  • May indicate circadian rhythm disorder or other sleep condition—consult a sleep specialist

"I score well but still feel tired"

This disconnect between assessment score and how you feel requires investigation.

Solution:

First, check your scoring honesty:

  • Are you rating based on how you think you sleep or actual patterns?
  • Re-read the questions and answer based on real data (track for a week if needed)
  • Pay special attention to Section B (Quality) questions

If your score is truly high (80+):

  1. You may have a sleep disorder the assessment can't detect:

    • Sleep apnea: Can have "enough hours" but poor quality due to breathing interruptions
    • Red flags: Snoring, gasping, morning headaches, partner reports breathing pauses
    • Action: See sleep medicine specialist for polysomnography

  2. Other health issues masquerading as sleep problems:

    • Anemia (check iron, B12 levels)
    • Thyroid dysfunction (get TSH tested)
    • Depression (fatigue is cardinal symptom)
    • Chronic fatigue syndrome or fibromyalgia
    • Action: See primary care doctor for blood work and evaluation

  3. Your sleep timing may not match your chronotype:

    • Scoring well on schedule consistency but forcing night owl into early schedule
    • Action: If possible, experiment with sleep timing aligned with natural preference

  4. Sleep inertia issues:

    • Waking mid-sleep cycle causes grogginess
    • Action: Try adjusting wake time by 15-30 minutes to align with 90-minute cycles

Reality check: If you genuinely sleep 7-9 hours, in good environment, with consistent timing, but still feel exhausted—this is medical, not behavioral.

"I can't remember my sleep quality accurately"

This is one of the most common and legitimate challenges with self-assessment.

Solution:

For the initial assessment:

  • Your general impression over the past month is actually fine for scoring
  • Don't overthink it—first instinct is usually accurate enough
  • Focus on patterns, not precision ("Usually" vs. "Sometimes" vs. "Rarely")

For ongoing tracking:

  1. Morning micro-journal (30 seconds):

    • Rate morning feeling: 1-5
    • Note bedtime and wake time
    • Any night wakings you remember
    • Do this immediately upon waking (before checking phone)

  2. Use objective data where available:

    • Phone's built-in sleep tracking (iPhone Health, Android Digital Wellbeing)
    • Many phones track bedtime/wake time automatically via movement
    • Wearable device (optional, not required)

  3. Weekly review method:

    • Every Sunday, reflect on the past week
    • Answer: "Did I generally feel rested this week?" (Y/N)
    • "How many nights had trouble falling asleep?" (0-7)
    • "How many nights woke frequently?" (0-7)
    • This weekly pattern is more useful than daily precision

What NOT to do:

  • Don't buy expensive sleep tracking equipment thinking it'll solve this
  • Don't obsess over exact metrics (minutes to fall asleep, etc.)
  • Don't wake yourself up to check time/tracking device

Truth: Subjective feeling of restedness in the morning is one of the best indicators, even if you can't remember the night's details.

"Assessment causes sleep anxiety"

This is Jordan's problem from the story—the assessment itself becomes a stressor.

Solution:

Immediate actions:

  1. Stop frequent reassessment.

    • If you're retaking weekly or daily: STOP
    • Limit to every 4-6 weeks maximum
    • The score is a tool, not a judgment

  2. Stop checking metrics at night.

    • No looking at sleep tracker during the night
    • Don't calculate "hours left" if you wake up
    • Don't check time if you wake up (cover clock if needed)

  3. Reframe the purpose:

    • The assessment identifies opportunities, not failures
    • Low score = specific things to improve (actionable)
    • Not a measure of your worth or discipline

Mindset shifts:

  • From: "I need a 90+ score or I'm failing"

  • To: "Any improvement from baseline is success"

  • From: "I have to track everything perfectly"

  • To: "General patterns over weeks are enough"

  • From: "Sleep is something I need to optimize"

  • To: "Sleep is natural; I'm just removing obstacles"

If anxiety persists:

  • Take a break from assessment entirely. Focus only on one or two behavioral changes for a month without measuring
  • Work with therapist on sleep anxiety (CBT-I - Cognitive Behavioral Therapy for Insomnia is evidence-based)
  • Consider whether perfectionism extends to other life areas (sleep anxiety often accompanies generalized anxiety)

Key principle: If the assessment hurts more than it helps, stop assessing. Your subjective experience ("Do I feel rested?") is valid data.

"My partner says I snore but I feel fine"

This is a critical warning sign that requires immediate attention.

Solution:

Why this matters:

  • You may have obstructive sleep apnea (OSA)
  • OSA causes breathing pauses during sleep—you don't wake fully, but sleep quality is destroyed
  • Your brain is repeatedly oxygen-deprived—this is dangerous
  • You feel "fine" because you don't remember the disruptions, but you're not getting restorative sleep

Red flags that increase concern:

  • Loud snoring (can be heard through closed door)
  • Gasping, choking, or snorting sounds during sleep
  • Pauses in breathing that partner witnesses
  • Morning headaches
  • Severe daytime sleepiness despite "adequate" sleep hours
  • Waking with dry mouth or sore throat
  • High blood pressure
  • Overweight/obese (major risk factor)
  • Large neck circumference (>17" men, >16" women)

Immediate actions:

  1. Document the evidence:

    • Have partner note frequency and severity
    • Consider recording yourself (audio/video) for one night
    • Note whether snoring is positional (worse on back)

  2. Take the STOP-BANG screening:

    • Snoring loudly
    • Tired during day
    • Observed breathing pauses
    • Pressure (high blood pressure)
    • BMI > 35
    • Age > 50
    • Neck circumference large
    • Gender male
    • Score 3+: High risk for sleep apnea

  3. See a doctor NOW (not eventually):

    • Primary care or sleep medicine specialist
    • Request sleep study (polysomnography)
    • This is typically covered by insurance with appropriate indication

  4. Don't dismiss this:

    • Untreated sleep apnea increases risk: 4x heart attack, 3x stroke, 2x diabetes
    • Associated with accidents (falling asleep at wheel)
    • Affects cognitive function, memory, mood

Temporary measures while awaiting evaluation:

  • Sleep on your side (not back)—sew tennis ball into back of sleep shirt
  • Avoid alcohol before bed (relaxes throat muscles)
  • Elevate head of bed 4-6 inches
  • Lose weight if overweight (even 10% helps)

What treatment looks like:

  • CPAP machine (Continuous Positive Airway Pressure) is gold standard
  • Modern CPAPs are quieter and more comfortable than old models
  • Oral appliances for mild cases
  • Surgery in specific anatomical cases

Bottom line: "Feeling fine" despite snoring is like saying "my smoke detector is beeping but I don't see fire"—the warning system is telling you there's a problem even if you can't perceive it directly. Take this seriously.

When Assessment Isn't the Answer​

Sometimes you don't need more assessment—you need action:

SituationInstead of ReassessingDo This
You know what the problem isTaking assessment againImplement the known solution
Score hasn't changed in 3 monthsRetaking same assessmentTry different intervention or seek professional help
Assessment causes stressMore frequent assessmentTake break, focus on how you feel
You have medical red flagsSelf-assessment toolsSee sleep specialist immediately

Remember: The assessment is a starting point for improvement, not an end in itself.

❓ Common Questions​

Frequently Asked Questions About Sleep Assessment

1. How often should I retake this assessment?​

Short Answer: Every 4-6 weeks while actively improving, then every 3 months for maintenance.

Detailed Guidance:

  • Active improvement phase: Retake monthly to track progress
  • Once optimized (score >80): Quarterly check-ins
  • After major life changes: Immediately (new job, move, baby, etc.)
  • If sleep worsens: Retake to identify what changed

Why: Sleep changes gradually. Too frequent assessment adds stress; too infrequent misses drift.

2. My score is low but I feel fine. Should I still care?​

Short Answer: Yes. Sleep deprivation impairs self-assessment ability.

The Science:

  • Studies show sleep-deprived people significantly underestimate their impairment
  • After one week of 6 hours/night, cognitive function matches 24 hours without sleep
  • BUT subjectively people report "feeling okay"
  • This disconnect is dangerous (like drunk driving—you feel more capable than you are)

Reality Check Questions:

  • Do you need an alarm to wake up?
  • Do you need caffeine to function?
  • Would you fall asleep if sitting in a quiet room mid-afternoon?
  • Do you "catch up" on weekends?

If yes to any, you're sleep-deprived even if you "feel fine."

The Truth: You don't know what "well-rested" feels like until you experience it.

3. Is 6 hours of sleep really that bad?​

Short Answer: Yes, for almost everyone.

The Numbers:

  • Only ~1% of population has gene variant for short sleep (true "short sleepers")
  • 99% of people need 7-9 hours
  • 6 hours = chronic sleep deprivation for most people

What Happens on 6 Hours:

  • After one week: cognitive function like being awake 24 hours straight
  • After two weeks: equivalent to being legally drunk (0.1% BAC)
  • Increased risk: +48% heart disease, +2x obesity, +3x diabetes
  • Immune function reduced by 50%

But I've done it for years:

  • Your performance has been impaired for years
  • Your baseline is artificially low
  • Health damage is cumulative
  • You don't know your actual potential

Exception: True short sleepers exist but are extremely rare. They wake refreshed after 5-6 hours naturally without alarm, have high energy all day without caffeine, maintain this even on weekends, and usually have family history of same pattern.

4. Does sleep quality matter more than quantity?​

Short Answer: You need both. Quantity enables quality.

The Reality:

  • You can't achieve deep sleep and REM without sufficient duration
  • Sleep cycles are ~90 minutes each
  • You need 4-6 complete cycles (6-9 hours)
  • "High quality 5-hour sleep" is mostly a myth

What Quality Really Means:

  • Uninterrupted cycles (not waking between them)
  • Proper environment (dark, cool, quiet)
  • Right timing (aligned with circadian rhythm)

Optimal Approach:

  1. Get sufficient duration (7-9 hours)
  2. Then optimize quality (environment, timing, habits)
  3. Not quality as excuse for less quantity

Truth: People who claim "I only need 5 hours of quality sleep" are usually just sleep-deprived with impaired self-assessment.

5. Can I make up sleep debt on weekends?​

Short Answer: Partially, but it's not ideal.

What Research Shows:

  • You can reduce some acute sleep debt
  • But you can't fully recover metabolic and cognitive costs
  • "Social jet lag" from shifting schedule causes problems
  • Weekend catch-up predicts weight gain and metabolic issues

The Math:

  • Weekday deficit: 5 days Ă— 1.5 hours = 7.5 hours behind
  • Weekend recovery: Can sleep extra 3-4 hours
  • Still 3-4 hours in debt
  • Then repeat cycle

Better Approach:

  • Prioritize consistency over catch-up
  • If you need weekend catch-up, weekday sleep is insufficient
  • Limit weekend shift to ±1 hour
  • Gradually increase weekday sleep until catch-up not needed

Analogy: Like binging on vegetables on weekends after eating poorly all week—better than nothing, but consistency is far superior.

6. What if my work schedule makes good sleep impossible?​

Short Answer: It's harder, but optimize what you can control.

Shift Workers:

  • Keep sleep schedule consistent on same shift
  • Make bedroom completely dark (blackout curtains essential)
  • Consider light therapy for circadian adjustment
  • Protect sleep time (don't schedule appointments during sleep hours)
  • Higher need for environmental optimization

Variable Schedules:

  • Anchor on wake time when possible
  • Use light/darkness strategically
  • Accept you'll never score 100—aim for best possible
  • Consider whether job is worth health cost long-term

High-Demand Jobs:

  • Sleep is performance enhancer, not obstacle
  • Successful people protect sleep (see: LeBron James, Jeff Bezos)
  • "I'll sleep when I'm dead" leads to sleep when you're dead sooner
  • Calculate true cost of poor sleep to productivity

Reality: Some situations are genuinely difficult, but most people have more control than they think.

Question to Ask: "Am I truly unable to improve sleep, or am I choosing to prioritize other things?"

✅ Quick Reference​

Sleep Assessment Summary Table

Score Ranges at a Glance​

ScoreGradeSleep QualityAction PriorityTypical SymptomsEst. Recovery Time
85-100AExcellentMaintainEnergetic, focused, stable moodN/A (maintain)
70-84BGoodLowMinor fatigue, slight afternoon dip2-4 weeks
55-69CFairMediumRegular fatigue, caffeine dependent4-8 weeks
40-54DPoorHighConstant tiredness, brain fog8-12 weeks
<40FCriticalUrgentSevere impairment, health risk12+ weeks + medical

Section Assessment Quick Guide​

SectionMax PointsWhat It MeasuresQuick FixRed Flag
A: Timing25Schedule consistency, durationSet consistent wake time>2 hour weekend shift
B: Quality30Sleep efficiency, feeling refreshedWind-down routineNever feel rested
C: Environment15Room darkness, temperature, noiseBlackout curtainsCan't control environment
D: Habits20Pre-sleep behavior, stimulantsScreen-free hourCaffeine after 4 PM
E: Daytime10Energy levels, alertnessUsually improves with A-DFalling asleep involuntarily

Common Sleep Issues Decision Tree​

Low Score?
├─ Yes → Which section is lowest?
│         ├─ Section A → Fix timing first (consistent wake time)
│         ├─ Section B → Check environment (C), then consider medical
│         ├─ Section C → Environmental fixes (easiest/fastest)
│         ├─ Section D → Behavior changes (screens, caffeine)
│         └─ Section E → Fix other sections first (symptom, not cause)
│
└─ No (85+) → Maintain current habits, periodic reassessment

Investment ROI Guide​

ChangeCostTime to ImplementExpected Score IncreaseDifficulty
Consistent wake timeFree2-3 weeks5-10 pointsMedium
No screens 1hr before bedFree1-2 weeks5-8 pointsMedium-Hard
Blackout curtains$30-100Immediate3-7 pointsEasy
Caffeine cutoff 2 PMFree1 week3-5 pointsMedium
Cool bedroom (65-68°F)VariesImmediate2-5 pointsEasy
Wind-down routineFree2-3 weeks4-6 pointsMedium
White noise machine$20-50Immediate2-4 pointsEasy
Weekend schedule consistencyFree2-4 weeks5-8 pointsHard

When to Seek Professional Help​

SymptomUrgencySpecialistWhat They'll Check
Loud snoring + gaspingHighSleep medicineSleep apnea (polysomnography)
Can't fall asleep (3+ months)MediumSleep medicineInsomnia disorder (CBT-I)
Extreme daytime sleepinessHighSleep medicineNarcolepsy, hypersomnia
Restless legs at nightMediumNeurologistRestless leg syndrome
Acting out dreamsMediumSleep medicineREM behavior disorder
Score <40 no improvementHighSleep medicineUnderlying disorders

Assessment Frequency Guide​

SituationFrequencyWhy
Active improvementEvery 4 weeksTrack progress, maintain motivation
Post-improvement (score >80)Every 3 monthsPrevent drift, catch early decline
After major life changeImmediatelyIdentify new issues
Stable and optimalEvery 6 monthsPeriodic check-in
Feeling worseImmediatelyEarly intervention

Key Metrics to Track Daily (Optional)​

MetricHow to TrackWhy It Matters
BedtimeNote or appConsistency is key predictor
Wake timeNote or appEven more important than bedtime
Sleep durationCalculate or wearableNeed 7-9 hours
Morning feeling (1-5)Quick ratingSubjective quality indicator
Daytime energy (1-5)Afternoon ratingWhether sleep was restorative

Realistic Expectations Timeline​

WeekExpected ProgressWhat You'll NoticeWhat's Still Hard
15-10% betterSome good nightsVery inconsistent
215-25% betterFalling asleep easierWeekend consistency
440-60% betterRegular good nightsOccasional setbacks
870-80% betterSleep feels naturalStress disrupts it
12+80-90% betterAutomatic good sleepLife happens sometimes

Important: Progress isn't linear. Bad weeks happen. Trend matters more than individual nights.

📚 Sources​

Evidence-Based References

Tier 1: Gold Standard (Meta-analyses, Large RCTs, Consensus Guidelines)​

  1. Watson NF, et al. (2015). "Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society." Journal of Clinical Sleep Medicine, 11(6), 591-592.

    • Key Finding: Adults need 7-9 hours of sleep per night for optimal health
    • Evidence Level: Consensus of 15+ major studies
    • Relevance: Basis for duration scoring in Section A

  2. Buysse DJ, et al. (1989). "The Pittsburgh Sleep Quality Index: A New Instrument for Psychiatric Practice and Research." Psychiatry Research, 28(2), 193-213.

    • Key Finding: Self-reported sleep quality predicts health outcomes
    • Evidence Level: Validated instrument, 10,000+ citations
    • Relevance: Model for this assessment structure
    • Note: PSQI is the gold standard; this assessment simplified for general use

  3. Van Dongen HP, et al. (2003). "The Cumulative Cost of Additional Wakefulness: Dose-Response Effects on Neurobehavioral Functions and Sleep Physiology from Chronic Sleep Restriction and Total Sleep Deprivation." Sleep, 26(2), 117-126.

    • Key Finding: 6 hours of sleep = cognitive impairment equal to 24 hours without sleep
    • Evidence Level: Controlled laboratory study, highly cited
    • Relevance: Justifies strict duration requirements

  4. Irwin MR, et al. (2016). "Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation." Biological Psychiatry, 80(1), 40-52.

    • Key Finding: Short sleep increases inflammatory markers
    • Evidence Level: Meta-analysis of 72 studies
    • Relevance: Health consequences in scoring interpretation

Tier 2: High Quality (Individual RCTs, Large Cohort Studies)​

  1. Czeisler CA, et al. (1999). "Stability, Precision, and Near-24-Hour Period of the Human Circadian Pacemaker." Science, 284(5423), 2177-2181.

    • Key Finding: Circadian rhythm disruption affects health independent of sleep duration
    • Evidence Level: Controlled laboratory study
    • Relevance: Importance of timing consistency in Section A

  2. Cappuccio FP, et al. (2010). "Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults." Sleep, 33(5), 585-592.

    • Key Finding: Short sleep associated with 2x obesity risk
    • Evidence Level: Meta-analysis
    • Relevance: Health risk scoring

  3. Okajima I, et al. (2011). "A Meta-Analysis on the Treatment Effectiveness of Cognitive Behavioral Therapy for Primary Insomnia." Sleep and Biological Rhythms, 9(1), 24-34.

    • Key Finding: Behavioral changes (sleep hygiene) highly effective
    • Evidence Level: Meta-analysis
    • Relevance: Justifies behavior-focused sections C & D

  4. Roehrs T, et al. (2003). "Sleep, Sleepiness, and Alcohol Use." Alcohol Research & Health, 27(2), 125-131.

    • Key Finding: Poor sleep impairs self-assessment of impairment
    • Evidence Level: Review of controlled studies
    • Relevance: Why objective assessment needed even when "feeling fine"

Tier 3: Good Quality (Observational Studies, Expert Reviews)​

  1. Hirshkowitz M, et al. (2015). "National Sleep Foundation's Sleep Time Duration Recommendations." Sleep Health, 1(1), 40-43.

    • Key Finding: Age-specific sleep duration recommendations
    • Evidence Level: Expert panel consensus
    • Relevance: Duration guidelines

  2. Irish LA, et al. (2015). "The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence." Sleep Medicine Reviews, 22, 23-36.

    • Key Finding: Environmental factors significantly impact sleep quality
    • Evidence Level: Systematic review
    • Relevance: Section C (Environment) scoring

  3. Chang AM, et al. (2015). "Evening Use of Light-Emitting eReaders Negatively Affects Sleep, Circadian Timing, and Next-Morning Alertness." Proceedings of the National Academy of Sciences, 112(4), 1232-1237.

    • Key Finding: Screen time before bed delays circadian rhythm and reduces sleep quality
    • Evidence Level: Controlled crossover study
    • Relevance: Section D (Habits) screen time scoring

  4. Drake C, et al. (2013). "Caffeine Effects on Sleep Taken 0, 3, or 6 Hours Before Going to Bed." Journal of Clinical Sleep Medicine, 9(11), 1195-1200.

    • Key Finding: Caffeine 6 hours before bed significantly disrupts sleep
    • Evidence Level: Controlled study
    • Relevance: Section D caffeine timing

Tier 4: Supportive Evidence (Case Studies, Clinical Experience)​

  1. Kline CE (2014). "The Bidirectional Relationship Between Exercise and Sleep: Implications for Exercise Adherence and Sleep Improvement." American Journal of Lifestyle Medicine, 8(6), 375-379.

    • Finding: Sleep and exercise relationship
    • Evidence Level: Narrative review
    • Relevance: Connection to other wellness areas

  2. American Academy of Sleep Medicine (2014). "Sleep Hygiene: Evidence for Effective Interventions."

    • Finding: Practical sleep improvement recommendations
    • Evidence Level: Clinical guidelines
    • Relevance: "Next Steps" recommendations

Assessment Validation Note​

This Assessment:

  • Adapted from Pittsburgh Sleep Quality Index (PSQI)
  • Simplified for self-administration without clinical scoring
  • Incorporates evidence-based sleep hygiene factors
  • Designed for educational and awareness purposes
  • NOT a diagnostic tool—clinical sleep disorders require professional evaluation

Limitations:

  • Self-report bias
  • Cannot detect sleep disorders (apnea, narcolepsy, etc.)
  • Cultural and individual variations
  • Point-in-time snapshot vs. longitudinal tracking

When Professional Assessment Needed:

  • Score <40 that doesn't improve
  • Suspected sleep-disordered breathing
  • Severe daytime impairment
  • Sleep issues lasting >3 months despite interventions

Additional Resources​

Clinical Guidelines:

  • American Academy of Sleep Medicine (AASM) - aasm.org
  • National Sleep Foundation - sleepfoundation.org
  • Sleep Research Society - sleepresearchsociety.org

Assessment Tools:

  • Pittsburgh Sleep Quality Index (PSQI) - Professional version
  • Epworth Sleepiness Scale - Daytime sleepiness
  • Insomnia Severity Index - Clinical insomnia

For Clinicians:

  • This assessment suitable for initial screening
  • Positive screen (score <55) warrants clinical evaluation
  • Not a replacement for validated diagnostic tools
  • Consider polysomnography for suspected disorders

💡 Key Takeaways​

Your Next Step

Based on your score:

  • 85-100: Maintain and protect what's working
  • 70-84: Pick ONE low-scoring question to address
  • 55-69: Start with Sleep Hygiene guide
  • Below 55: Make sleep your #1 priority—read Sleep Science

Remember: Sleep is foundational. Improving sleep improves everything else.

🔗 Connections​