Daily Sleep Log

  • Indicate date you went to bed.
  • :
    A. What time did you physically get into bed?
  • :
    B. At about what time did you engage sleep effort or "try" to go to sleep?
  • C. Estimate how long it took you to fall asleep once trying to do so. In hours or minutes.
    (0.00-12.00 hours or 0.00-720.00 minutes)
  • D. Once asleep, about how many times did you wake (not including the finial time)?
  • E. Estimate the total amount of time you were awake during all of your awakenings combined in hours.
    (.25 for 15 mins., .5 for 30 mins., .75 for 45 mins.)
  • :
    F. At about what time did you wake for the finial time (before getting out of bed)?
  • :
    G. What time did you get out of bed to rise for the day?
  • H. What is the number of hours you were in bed from the time you "tried" to go to sleep to the final time before getting out of bed?
    (.25 for 15 mins., .5 for 30 mins., .75 for 45 mins.)
  • Based on calculation: B & F minus E