Sleep Diary Log
Keeping a sleep diary can help you and your healthcare provider better understand your sleep patterns.
Fill this out each morning based on the previous night. Consult with your healthcare provider regarding your sleep symptoms and patterns.
Daily Sleep Record
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Date |
Time You Went to Bed |
Time You Tried to Sleep |
Time You Fell Asleep |
Number of Times You Woke Up |
Total Time Awake During the Night |
Time You Woke Up for the Day |
Time You Got Out of Bed |
Total Sleep Time (estimate) |
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Click here for a printer-friendly Sleep Diary/Log
Sleep Quality
Circle one:
Poor / Fair / Good / Very Good / Excellent
Daytime Habits
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Naps? (Y/N) |
Nap Length |
Caffeine Today? (Y/N) |
Exercise Today? (Y/N) |
Alcohol Today? (Y/N) |
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Evening Factors
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Screen Time Before Bed? |
Late Meal? |
Stress or Worry? |
Pain or Discomfort? |
Medications or Sleep Aids
Did you take anything to help with sleep?
☐ Yes
☐ No
If yes, what did you take?
Morning Feelings
How did you feel when you woke up?
☐ Rested
☐ Somewhat tired
☐ Very tired
☐ Alert
Notes
Anything unusual about your sleep?
Examples:
- Noise
- Bathroom trips
- Temperature
- Dreams
- Illness
Weekly Summary
At the end of the week, reflect:
Did you notice:
☐ Trouble falling asleep
☐ Frequent awakenings
☐ Early waking
☐ Daytime fatigue
Medical Disclaimer
This sleep diary is for informational and tracking purposes only and is not intended to diagnose or treat any medical condition. Individuals experiencing ongoing sleep difficulties should consult their healthcare provider for evaluation and guidance. This tool should be used as a supplement to, not a replacement for, professional medical advice.
This handout is for educational purposes only and is not a substitute for professional medical advice. Always follow your healthcare provider’s instructions.
This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.