
Sleep diary
נבדק על ידי Dr Hayley Willacy, FRCGP עודכן לאחרונה על ידי Danny ChadburnLast updated 11 ספטמבר 2017
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Please answer questions A to S each day over the next two weeks. There should be three sheets of paper for answers to be written in boxes. The aim is to measure the pattern and quality of your sleep, and factors that may affect your sleep over the course of two weeks.
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Questions A to I relate to the night's sleep. Try to answer these soon after getting up each day when the details of the previous night are fresh in your mind.
Questions J to S relate to to the day leading up to the night's sleep. Try to answer these at least an hour before you go to bed when the details are fresh in your mind.
ה. What time did you wake up this morning?
B. What time did you go to bed last night?
פ. About how long did it take to first fall asleep? (Record in minutes - for example, 70 mins.)
D. How many times did you wake up during the night (enough to be fully aware)?
E. How long did you sleep last night in total? (In hours and minutes - for example, 4 hr 30 mins.)
F. Did you take any sleeping tablets last night to help you sleep?
G. How generally well do you feel today? Record on a scale 1-4. 1 - not well at all. 2 - just OK. 3 - fine. 4 - very well.
תופעות לוואי של הידרוקסיזין. How energetic do you feel today? Record on a scale 1-4. 1 - lethargic. 2 - slow but OK. 3 - fine. 4 - very energetic.
כ. How enjoyable was your sleep last night? Record on a scale 1-4. 1 - not at all. 2 - just OK. 3 - fine. 4 - very good.
J. How many cups of caffeine drinks (tea, coffee, cola, etc) did you have before 5 pm?
ש. How many cups of caffeine drinks (tea, coffee, cola, etc) did you have after 5 pm?
L. How many units of alcohol did you have before 5 pm? One unit of alcohol is about equal to: half a pint of ordinary-strength beer/lager, or a small pub measure (25 ml) of spirits, or a standard pub measure (50 ml) of sherry or port, or a small glass of ordinary-strength wine.
M. How many units of alcohol did you have after 5 pm?
נ. How much moderate or vigorous physical activity/exercise did you do before 9 pm? (Record in minutes - for example, 40 mins.) Moderate physical activity/exercise includes brisk walking, jogging, dancing, swimming, heavy DIY, gardening, etc.
תופעות לוואי של אוקסיטטרציקלין. How much moderate or vigorous physical activity/exercise did you do after 9 pm?
P. Did you take any street drugs (cocaine, amfetamines, heroin, etc)? Yes/No. If yes, write down which one(s).
Q. Did you have any naps during the day or evening? Yes/No.
R. If you did nap, how long in total were the naps? Record in minutes.
ו. Fill in any other details that may be relevant. For example, if you were particularly stressed, anxious, depressed or ill.
sleep diary questions 1

Sleep diary question 2

Sleep diary questions 3

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About the author

Danny Chadburn
Head of Content
Danny was the previous Head of Content at Patient.
About the reviewerView full bio

Dr Hayley Willacy, FRCGP
General Practitioner, Medical Author
MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)
Dr Hayley Willacy was an NHS GP working in northwest England, who retired from clinical practice in 2022 after 30 years.
היסטוריית המאמר
המידע בעמוד זה נבדק על ידי קלינאים מוסמכים.
11 ספטמבר 2017 | הגרסה האחרונה

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