Day-time wakefulness 

What is your gender?
What is your age in years?
How many cups of coffee, on average, do you consume in a 24 hour period?
How many cups of water, on average, do you consume in a 24 hour period?
How would you rate your day-time wakefulness level, on an average day?
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On average, how many hours of sleep do you get in a 24 hour period?
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