No.

Ground

Yes

No

1.

Are you physically and mentally ready to participate in this research?

2.

Have you slept last 24 hours?

If your answer is “yes”, then mention the duration: ............................. hours/minute

3.

Is it your habit to sleep less?

If your answer is “yes”, then how many hours do you sleep daily? ................. hours

4.

Do you suffer from insomnia?

5.

Are you suffering from any types of brain injury?

If yes, when ..............................................?

6.

Are you suffering from Alzheimers, Dementia or any other mental disease? If so, then mention ................................................................

7.

Are you suffering from any disease or physical illness right now?

If so, then mention those: ..............................................................

8.

Are you taking any medicine for any reason?

If so, then mention those: ...........................................................

9.

Did you ever get a hit at your brain in the past?

If so, then when?..................... Did you get admitted to a hospital? ..........................

10.

Did you suffer from any deadly disease in the past?

If so, then when?..................... Did you get admitted to a hospital? ........................................

11.

Have you taken coffee, energy drink, alcohol or smoked in last 24 hours?

12.

Have you taken any chocolates/lozenge/toffee in last 24 hours?

13.

Have you recorded your daily activities in the Sleep Log that you were given?