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The Sleep Survey

Participant Information Sheet 1: Questionnaire Measures

Study Title: Understanding the impact of insomnia on daytime function

Researcher:    Louise Baker                                                   Ethics number:6211

Please read this information carefully before deciding to take part in this research. If you are happy to participate please read the informed consent form to proceed.

I am Louise Baker, a third year PhD student investigating the impact of insomnia on daytime function. I am requesting your participation in this study because you consider yourself to be a poor sleeper. I would like to better understand, from the perspective of the individual, how this complaint affects day to day life.

This part of the study will involve a series of short questionnaires that will take approximately 15 minutes and you will receive one credit. If you are eligible for the rest of the study which involves diary measures and an interview we will contact you within the next few days (16 credits). The diary measure will take the form of short dictaphone entries each day for one week. The interview will last around half an hour.

Personal information will not be released to or viewed by anyone other than the researchers involved in this project. Results of this study will not include your name or any other identifying characteristics. Your data has linked anonymity which means that only the researcher is able to match your ID to the new unique code given to your data. This study has received approval from the School Ethics committee and the University Research Governance Office.  All data will be stored safely on a password protected computer.

Your participation in this study is voluntary and you may wish to withdraw at any time. In this event, there will be no consequence to your grade or to your treatment as a student in the Psychology department.

If you have any questions please contact me at You can also contact Dr Felicity Bishop ( or my primary supervisor Dr Matt Garner at

If you have questions about your rights as a participant in this research, or if you feel that you have been placed at risk, you may contact the Chair of the Ethics Committee, Department of Psychology, University of Southampton, Southampton, SO17 1BJ.

Phone:  (023) 8059 5578



(Part 1: Questionnaire measures)


Study title: Understanding the impact of insomnia on daytime function

Researcher name: Louise Baker       

Study reference: 6211

Ethics reference:6211


I have read and understood the information sheet and have had the opportunity to ask questions about the study.

I agree to take part in this research project and agree for my data to be used for the purpose of this study.

I understand my participation is voluntary and I may withdraw at any time without my legal rights being affected .

I am happy to be contacted regarding other unspecified research projects. I therefore consent to the University retaining my personal details on a database, kept separately from the research data detailed above. The ‘validity’ of my consent is conditional upon the University complying with the Data Protection Act and I understand that I can request my details be removed from this database at any time.


Data Protection

I understand that information collected about me during my participation in this study will be stored on a password protected computer and that this information will only be used for the purpose of this study. All files containing any personal data will be made anonymous.


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