Canadian Community Health Survey (CCHS) - Rapid Response - Sleep quality and Positive mental health
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
Sleep quality (SLE)
Sleep quality (SLE) - Question identifier:SLE_R01
The next questions are about your sleep.
Sleep quality (SLE) - Question identifier:SLE_R01B
First, we want to know details about your sleep in the past 7 days.
Sleep quality (SLE) - Question identifier:SLE_Q01A
On weekdays, at what time did you usually fall asleep?
Hour
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Sleep quality (SLE) - Question identifier:SLE_Q01B
On weekdays, at what time did you usually fall asleep?
Minutes
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Sleep quality (SLE) - Question identifier:SLE_Q01C
On weekdays, at what time did you usually fall asleep?
a.m. or p.m.
- 1: a.m
- 2: p.m
Sleep quality (SLE) - Question identifier:SLE_Q02A
On weekdays, at what time did you usually wake up?
Hour
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Sleep quality (SLE) - Question identifier:SLE_Q02B
On weekdays, at what time did you usually wake up?
Minutes
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Sleep quality (SLE) - Question identifier:SLE_Q02C
On weekdays, at what time did you usually wake up?
a.m. or p.m.
- 1: a.m
- 2: p.m
Sleep quality (SLE) - Question identifier:SLE_Q03A
On weekend days, at what time did you usually fall asleep?
Hour
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Sleep quality (SLE) - Question identifier:SLE_Q03B
On weekend days, at what time did you usually fall asleep?
Minutes
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Sleep quality (SLE) - Question identifier:SLE_Q03C
On weekend days, at what time did you usually fall asleep?
a.m. or p.m.
- 1: a.m
- 2: p.m
Sleep quality (SLE) - Question identifier:SLE_Q04A
On weekend days, at what time did you usually wake up?
Hour
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Sleep quality (SLE) - Question identifier:SLE_Q04B
On weekend days, at what time did you usually wake up?
Minutes
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Sleep quality (SLE) - Question identifier:SLE_Q04C
On weekend days, at what time did you usually wake up?
a.m. or p.m.
- 1: a.m
- 2: p.m
Sleep quality (SLE) - Question identifier:SLE_Q15
Overall, how would you rate your sleep quality over the past 7 days?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
Sleep quality (SLE) - Question identifier:SLE_Q45
In the past 7 days, on how many days did you wake up 3 or more times during your sleep?
- 0: 0
- 1: 1
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7
Positive mental health (PMS)
Positive mental health (PMS) - Question identifier:PMS_Q05
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling optimistic about the future.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q10
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling useful.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q15
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling relaxed.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q20
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling interested in other people.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q25
The following questions are about how you have been feeling during the past 2 weeks.
I've had energy to spare.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q30
The following questions are about how you have been feeling during the past 2 weeks.
I've been dealing with problems well.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q35
The following questions are about how you have been feeling during the past 2 weeks.
I've been thinking clearly.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q40
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling good about myself.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q45
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling close to other people.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q50
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling confident.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q55
The following questions are about how you have been feeling during the past 2 weeks.
I've been able to make up my own mind about things.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q60
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling loved.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q65
The following questions are about how you have been feeling during the past 2 weeks.
I've been interested in new things.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q70
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling cheerful.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
- Date modified: