Sleep Journal
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
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
