Printable form
One-week sleep diary
Memory is a poor record of a bad night. This form lets you write down a week of sleep in a couple of minutes each morning, so you can see your real pattern and, if you decide to see a clinician, show it to them. Print it, put it by the bed with a pen, and fill in the first part each morning and the second part each evening.
| Day and date | Time into bed | Minutes to fall asleep (estimate) | Times woken in the night and for how long | Final wake time | Time out of bed | Sleep quality (1 poor to 5 good) |
|---|---|---|---|---|---|---|
| Day 1 | ||||||
| Day 2 | ||||||
| Day 3 | ||||||
| Day 4 | ||||||
| Day 5 | ||||||
| Day 6 | ||||||
| Day 7 |
| Day | Naps (time and length) | Caffeine (what and when) | Alcohol (amount and when) | Exercise (type and when) | Medicines taken (as usual) | Daytime energy and mood (1 low to 5 high) |
|---|---|---|---|---|---|---|
| Day 1 | ||||||
| Day 2 | ||||||
| Day 3 | ||||||
| Day 4 | ||||||
| Day 5 | ||||||
| Day 6 | ||||||
| Day 7 |
This page stores nothing. It is a blank form for you to print and fill in by hand. Notes: write down medicines only as you normally take them, and never change a medicine because of what the diary shows.
How to fill it in
- Use your best estimates. Do not watch the clock during the night; a rough guess is what matters.
- Record every day for seven days, including weekends, so you can compare them.
- Write what actually happened, not what you think should have happened.
- Note unusual events such as illness, travel, a late night or a stressful day in the margin.
How to read your week
Look for patterns rather than single nights. Is your wake time steady? Do weekend bed and wake times drift by more than an hour or so? Does a late coffee, an afternoon nap or an evening drink show up before your worst nights? Add up your time asleep for a few nights: if it is regularly under seven hours as an adult, the time you give yourself for sleep may be the first thing to look at. A simple pattern can point to an easy change, such as moving the alarm or the last coffee, which you can test for another week. Estimates of time asleep are rough, since people tend to misjudge how long they were awake.
When to take it to a clinician
If a week or two of notes shows long stretches awake most nights, heavy daytime sleepiness, or anything that worries you, bring the diary to an appointment. The questions checklist helps you prepare. A diary cannot diagnose a sleep disorder, and it should never be used to start, stop or change medicine.
Go deeper
- How to improve sleep quality
- Why you cannot fall asleep at night
- Bedtime and wake-time planner
- Sleep environment checklist
Where this comes from
A written sleep log is a common first step in sleep-medicine practice, and sleep specialists and professional societies such as the American Academy of Sleep Medicine publish sleep diary forms for this purpose (their patient education site offers a printable two-week diary). The columns here cover the usual items: bed and wake times, time to fall asleep, night wakings, naps, caffeine, alcohol and daytime function. Guidance on consistent timing, limiting late caffeine and alcohol, and seven or more hours for most adults comes from Centers for Disease Control and Prevention and National Heart, Lung, and Blood Institute material read in October 2026. This form is an original layout and is not a clinical instrument.