Sleep Journal
Topic Overview
Fill out this sleep journal every morning for 1 to 2 weeks. It can help you see what gets in the way of a good night’s sleep. It could also help your doctor know more about what affects your sleep.
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What time did you go to bed last night? |
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How long did it take to fall asleep? |
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What time did you get up? |
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Did you wake up during your sleep time? How many times? For how long? Did you get out of bed? |
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How much total sleep did you get? |
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How tired do you feel, on a scale of 1 to 5? (Very tired = 5) |
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Overall, how tired did you feel yesterday, on a scale of 1 to 5? (Very tired = 5) |
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How unusual or stressful was your day yesterday, on a scale of 1 to 5? (Very unusual or stressful = 5) |
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What did you do during the 30 minutes before bed? |
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Yesterday, did you: Take any naps? How long? When? |
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Yesterday, did you: Drink alcohol? How much? |
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Yesterday, did you: Have any caffeine? How much? When? |
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Yesterday, did you: Do any physical activity? What? When? |
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Yesterday, did you: Eat big or spicy meals? What? When? |
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Yesterday, did you: Take any medicines, including over-the-counter or herbal ones? What? When? |
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Current as of: May 28, 2019
Author: Healthwise Staff
Medical Review:Kathleen Romito MD – Family Medicine & Adam Husney MD – Family Medicine & Lisa S. Weinstock MD – Psychiatry
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