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SleepFoundation SleepLog

The document is a sleep log that collects information about an individual's sleep habits over the course of a week. It asks questions about napping, caffeine/alcohol/nicotine consumption after 6pm, exercise, heavy meals after 6pm, sleep medication use, daytime sleepiness, bedtime, wake time, total sleep hours, night wakings, sleep quality, and whether enough sleep was achieved. The log is meant to be filled out daily for a week to gain insight into sleep patterns and potential disruptors.

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Sahar Malik
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146 views1 page

SleepFoundation SleepLog

The document is a sleep log that collects information about an individual's sleep habits over the course of a week. It asks questions about napping, caffeine/alcohol/nicotine consumption after 6pm, exercise, heavy meals after 6pm, sleep medication use, daytime sleepiness, bedtime, wake time, total sleep hours, night wakings, sleep quality, and whether enough sleep was achieved. The log is meant to be filled out daily for a week to gain insight into sleep patterns and potential disruptors.

Uploaded by

Sahar Malik
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SleepFoundation

Sleep Log Please fill this out for the previous day and night no more than 3 hours after waking.
The information can be an estimate when necessary. A OneCare Media Company

NAME WEEK OF

DAY SUN MON TUES WED THURS FRI SAT

Did you nap? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

For how long? mins. mins. mins. mins. mins. mins. mins.

At what time?

Did you have any caffeine* after 6pm? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Did you drink alcohol after 6pm? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Did you use nicotine after 6pm? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Did you exercise? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Did you eat a heavy meal or snack after 6pm? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Did you take any sleeping medication Yes No Yes No Yes No Yes No Yes No Yes No Yes No

What medication?

Amount

At what time?

Were you sleepy during the day? Yes No Yes No Yes No Yes No Yes No Yes No Yes No

NIGHT
What time did you turn off the lights
to go to sleep?

What time did you wake up?

How many total hours did you sleep?

How many times did you wake up in the night?

Rate the quality of your sleep:

Do you feel you got enough sleep?

* Caffeine = coffee, tea, caffeinated soda, chocolate, energy drinks, certain medications.

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