Weekly Sleep Log printable pdf download

Weekly Sleep Log

WEEKLY SLEEP LOG

Day of the Week:

Calendar Date:

1. Yesterday I napped from ____ to ____ (note time of all naps).

2. Last night I took ___ mg of ___ or ___ of alcohol as a sleep aid

(include all prescription and over-the-counter sleep aids).

3. Last night I got in my bed at ____ (AM or PM).

4. Last night I turned off the lights and attempted to fall asleep

at ____ (AM or PM).

5. After turning off the lights, it took me about ____ minutes to

fall asleep.

6. I woke from sleep ____ times. (Do not count your final

awakening here)

7. My awakenings lasted ____ minutes. (List each awakening

separately)

8. Today I woke up at ____ (AM or PM). (Note: this is your final

awakening).

9. Today I got out of bed for the day at ____ (AM or PM).

10. I would rate the quality of last night’s sleep as:

Very Poor

Fair

Well Rested

11. How well rested did you feel upon arising today?

Not at all

Somewhat

Well Rested

Weekly Sleep Log