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PHI stands for "Protected Health Information" (Y = Yes, N = No)
Display Field Phi Field type Condition choices Field note Header
...and it takes me ______ minutes to fall asleep_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else. mctq_7 N text - - -
...and then it takes me ______ minutes to fall asleep_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else._x000D_ mctq_17 N text - - -
...but generally I fall asleep after no more than ______ minutes_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else._x000D_ mctq_20 N text - - -
Are you currently working? mctq_1a N yesno - - -
As a child, I was mctq_25 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
As a teenager, I was mctq_26 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
At around ______ hours (use 24-hour time), I have an energy dip_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ _x000D_ _x000D_ mctq_15 N text - - -
At around ________ hours (use 24-hour time), I have an energy dip_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ mctq_5 N text - - -
Because I would feel terrible afterwords mctq_8b N radio 0, Not correct | 1, Correct - -
Because I would feel terrible afterwords mctq_18b N radio 0, Not correct | 1, Correct - -
Father mctq_29 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
From ______ hours (use 24-hour time), I am fully awake_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ mctq_14 N text - - -
From ________ hours (use 24-hour time), I am fully awake_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ mctq_4 N text - - -
I am mctq_24 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - After you have answered the preceding questions, you should have a feeling for which chronotype (time-of-day-type) you belong to. If for example, you like (and manage) to sleep quite a bit longer on free days than on workdays, or if you cannot get out of bed on Monday mornings, even without a Sunday-night-party, then you are more a late type. If, however, you regularly wake up and feel perky once you jump out of bed, and if you would rather go to bed early than to an evening concert you are an early type. In the following questions, you should categorize yourself and your family members.
I get up at __________ hours (use 24-hour time)_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ _x000D_ _x000D_ mctq_1 N text - - On workdays:
I have ___ siblings mctq_30a N dropdown 0, 0 | 1, 1 | 2, 2 | 3, 3 | 4, 4 | 5, 5 | 6, 6 | 7, 7+ - -
I need ______ minutes to wake up_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else. mctq_13 N text - - -
I need ___________ minutes to wake up_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else._x000D_ mctq_2 N text - - -
I normally wake up at ______ hours (use 24-hour time) _x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ mctq_10 N text - - -
I prefer to sleep in a completely dark room mctq_21 N radio 0, Not correct | 1, Correct - -
I regularly wake up... mctq_3 N radio 0, Before the alarm | 1, With the alarm - -
I then sleep for ______ minutes_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else. mctq_8a N text - - -
I then sleep for ______ minutes_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else._x000D_ mctq_18a N text - - -
I wake up more easily when morning light shines into my room mctq_22 N radio 0, Not correct | 1, Correct - -
If I get back to sleep, I sleep for another ______ minutes_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else. mctq_12 N text - - -
If I get the chance, I like to take a siesta/nap mctq_18 N radio 0, Not correct | 1, Correct - -
If I get the chance, I would like to take a siesta/nap mctq_8 N radio 0, Not correct | 1, Correct - -
If I wake up at around the normal (workday) alarm time, I try to get back to sleep mctq_11 N radio 0, Not correct | 1, Correct - -
In case you are older than 65: in the middle of my life, I was mctq_27 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
Mother mctq_28 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - My parents are/were
My dream would be to sleep until ______ hours (use 24-hour time) _x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ _x000D_ _x000D_ mctq_9 N text - - On free days (please only judge normal free days, i.e., without parties)
My partner is/was... mctq_31 N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
Notes mctq_notes Y notes - - -
On free days mctq_23b N text - Please specify in hours and minutes -
On nights before free days, I go to bed at ______ hours (use 24-hour time) _x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ _x000D_ mctq_16 N text - - -
On nights before workdays, I go to bed at ______ hours (use 24-hour time)_x000D_ _x000D_ Enter values from 00:00 to 23:59:_x000D_ 1:00 is 1 am, early morning,_x000D_ 12:00 is noon, also called 12 PM,_x000D_ 14:00 is 2pm, early afternoon,_x000D_ 20:00 is 8pm, the evening,_x000D_ 23:59 is 11:59 pm, late evening_x000D_ 00:00 is midnight, also called 12 AM,_x000D_ 00:30 is 30 minutes after midnight_x000D_ mctq_6 N text - - -
On work days mctq_23a N text - Please specify in hours and minutes How long per day do you spend on average outside (really outside!!) exposed to day light?
Once I am in bed, I would like to read for ______ minutes_x000D_ _x000D_ Enter a whole number that is a number of MINUTES._x000D_ You should not enter any words or punctuation. If_x000D_ the # of minutes is 15 ( 1/4 of an hour), enter 15_x000D_ and nothing else. If the time duration is two hours,_x000D_ enter 120 and nothing else._x000D_ mctq_19 N text - - -
Sibling #1 is my (brother/sister) mctq_30b N radio 1, Brother | 2, Sister - -
Sibling #2 is my (brother/sister) mctq_30d N radio 1, Brother | 2, Sister - -
Sibling #3 is my (brother/sister) mctq_30f N radio 1, Brother | 2, Sister - -
Sibling #4 is my (brother/sister) mctq_30h N radio 1, Brother | 2, Sister - -
Sibling #5 is my (brother/sister) mctq_30j N radio 1, Brother | 2, Sister - -
Sibling #6 is my (brother/sister) mctq_30l N radio 1, Brother | 2, Sister - -
Sibling #7 is my (brother/sister) mctq_30n N radio 1, Brother | 2, Sister - -
and is... mctq_30c N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30e N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30g N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30i N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30k N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30m N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -
and is... mctq_30o N dropdown 0, Extreme early type | 1, Moderate early type | 2, Slight early type | 3, Normal type | 4, Slight late type | 5, Moderate late type | 6, Extreme late type - -

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