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.
| Day |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
| What time did you go to bed last night? |
|
|
|
|
|
|
|
| How long did it take to fall asleep? |
|
|
|
|
|
|
|
| What time did you get up? |
|
|
|
|
|
|
|
| Did you wake up during your sleep time? How many times? For how long? Did you get out of bed? |
|
|
|
|
|
|
|
| How much total sleep did you get? |
|
|
|
|
|
|
|
|
|
| How tired do you feel, on a scale of 1 to 5? (Very tired = 5) |
|
|
|
|
|
|
|
| Overall, how tired did you feel yesterday, on a scale of 1 to 5? (Very tired = 5) |
|
|
|
|
|
|
|
| How unusual or stressful was your day yesterday, on a scale of 1 to 5? (Very unusual or stressful = 5) |
|
|
|
|
|
|
|
|
|
| What did you do during the 30 minutes before bed? |
|
|
|
|
|
|
|
| Did you take any naps yesterday? How long? When? |
|
|
|
|
|
|
|
| Did you drink alcohol yesterday? How much? |
|
|
|
|
|
|
|
| Did you have any caffeine yesterday? How much? When? |
|
|
|
|
|
|
|
| Did you do any physical activity yesterday? What? When? |
|
|
|
|
|
|
|
| Did you eat big or spicy meals yesterday? What? When? |
|
|
|
|
|
|
|
| Did you take any medicines yesterday, including over-the-counter or herbal ones? What? When? |
|
|
|
|
|
|
|
Credits
Current as of: October 1, 2025
Current as of: October 1, 2025