Sleep Diary

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For those who suffer from sleeping problems, it’s sometimes helpful to keep a sleep diary as this can help medical professionals identify not only sleep problems but other health problems. Although this diary is for one week, you can print more than one copy if needed.

Complete the diary each morning (“Day 1” will be your first morning). Don’t worry too much about giving exact answers; an estimate will do.


The sleep diary

Your Name__________________________________       The date of Day 1_______________

Enter the Weekday (Mon, Tues, Wed, etc.)Day 1Day 2Day 3Day 4Day 5Day 6Day 7
1At what time, did you go to bed last night?
2After settling down, how long did it take you to fall asleep?
3After falling asleep, about how many times did you wake up in the night?
4After falling asleep, for how long were you awake during the night in total?
5At what time, did you finally wake up?
6At what time, did you get up?
7How long did you spend in bed last night (from first getting in, to finally getting up)
8How would you rate the quality of your sleep last night?

1      2      3      4      5

V. Poor                      V. Good

Click here to print the image above

Source: NHS website.[1]



[1]NHS, Sleep Diary, Http://Www.Nhs.Uk/Livewell/Insomnia/Documents/Sleepdiary.Pdf

(Accessed on November 20, 2016)

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