Goal Sleep Activity Chart

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GOAL SLEEP/ACTIVITY CHART (Source: Sleepless In America, Mary Sheedy Kurcinka)
Name_____________
Age__________
For Sleeping
WA=Wake Time
For Eating: M=meal or snack
For awake time: E=Exercise or active play
N=Naptime
O=Outside time
B=Bedtime
A=Other activities
S=Sleep Time
TIME
Sample
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
5 a.m.
S
6 a.m.
S
7 a.m.
WA
8 a.m.
M
9 a.m.
O/E
10a.m.
11 a.m.
12 p.m.
M
1 p.m.
N
2 p.m.
N
3 p.m.
4.p.m.
5 p.m.
M
6 p.m.
7 p.m.
B
8.p.m.
S
9 p.m.
S
10 p.m.
S
11 p.m.
S
12 p.m.
S
1 a.m.
S
2 a.m.
S
3 a.m.
S
4 a.m.
S
Total Hrs of Sleep
12 Hrs
Behavior
Source: Sleepless In America, Mary Sheedy Kurcinka

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