Sleep Diary
The Importance of Sleep Diaries
Sleep diaries are the foundation of CBT-I, used to objectively record your sleep patterns. Many insomnia sufferers have misconceptions about their sleep, often overestimating wake time and underestimating actual sleep time. Through systematic recording, you can:
- Identify factors and patterns affecting your sleep
- Provide necessary data for Sleep Restriction Therapy
- Monitor treatment progress
- Provide information needed for assessment by healthcare professionals
How to Keep a Sleep Diary
Complete your recording as soon as possible after waking each morning, avoiding reliance on memory. Record these key pieces of information:
Sleep Times
- Bedtime: When you got into bed and prepared to sleep (not when you entered the bedroom)
- Sleep onset time: Your estimate of approximately when you fell asleep
- Night awakenings: Number of times you woke up and estimated total time awake
- Final wake time: When you last woke up in the morning
- Get-up time: When you actually got out of bed
Sleep Quality
- Sleep efficiency: Total sleep time ÷ total time in bed × 100%
- Subjective rating: Rating of sleep quality (1-5 or very poor to very good)
- Morning feeling: Mental state and feeling of restoration upon waking
Influencing Factors
- Daytime activities: Exercise, work stress, significant events
- Substance intake: Caffeine, alcohol, medication use
- Pre-sleep activities: Screen use, eating, relaxation activities
- Environmental factors: Noise, light, temperature, partner disturbance
Sleep Diary Example
| Date | Bedtime | Sleep Onset | Night Awakenings | Final Wake | Get-up Time | Total Sleep | Sleep Efficiency |
|---|---|---|---|---|---|---|---|
| June 1 | 11:00 PM | 11:45 PM | 2 times, 60 min | 6:30 AM | 7:00 AM | 5.75 hours | 72% |
| June 2 | 11:15 PM | 11:30 PM | 1 time, 30 min | 6:15 AM | 6:45 AM | 6.25 hours | 82% |
| June 3 | 11:00 PM | 11:20 PM | 3 times, 45 min | 6:00 AM | 6:30 AM | 5.92 hours | 79% |
Analyzing Your Sleep Diary
After recording for 1-2 weeks, look for these patterns:
- Sleep efficiency: Calculate average sleep efficiency (85% or above is ideal)
- Total sleep time: Calculate average actual sleep time
- Sleep onset latency: How long it takes on average to fall asleep (over 30 minutes indicates a problem)
- Night awakenings: Frequency and duration of night wakings
- Related factors: Which daytime activities or habits correlate with good/poor sleep
This data will help you and healthcare professionals determine the most appropriate CBT-I interventions. For example, if your main issue is difficulty falling asleep, stimulus control may be particularly effective; if sleep efficiency is low, sleep restriction may be more important.
Frequently Asked Questions
How long should I keep a sleep diary?
Record for at least 1-2 weeks before starting CBT-I treatment to establish a baseline. During treatment, continue recording to track progress. Some people find maintaining this habit helpful for long-term good sleep.
How do I know when I fall asleep? I don't know when I'm asleep
This is a common question. Record your best estimate, usually the last time you remember. Over time, you'll become better at estimating. If available, consider using a sleep tracking device to assist with recording.
Will keeping a sleep diary make me more anxious about my sleep?
Some people do experience this. If recording causes anxiety, you can simplify what you record, or ask a partner to help with recording. It's important to view recording as an objective data collection tool, not a way to judge sleep quality.