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    Sleep Worksheet - 01 - Sleep Diary

    Uploaded by

    Cláudia Almeida

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Sleep Worksheet - 01 - Sleep Diary

    Uploaded by

    Cláudia Almeida
    204 views1 page

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    204 views1 page

    Sleep Worksheet - 01 - Sleep Diary

    Uploaded by

    Cláudia Almeida

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    sleep diary

    Use this sleep diary to make an accurate assessment of how much you sleep and
    other factors associated with your sleep. This will help you to identify patterns and
    areas for improving sleep hygiene. Also, many people who struggle with sleep
    difficulties make negative assumptions about their sleep (e.g. “I never sleep more than
    5 hours a night”) and this worksheet can help you to check if this is really the case.

    Pre-sleep information Bed/sleep pattern


    Day/Date Naps (what Caffeine, Medication Pre-bed Day fatigue Tension in In-bed Lights out Time to fall Waking Hours slept Woke up? Rest score
    time & how alcohol, nico- (day total & activity level (0-5, 5 bed (0-5, 5 activities (time) asleep time (number of (0-5, 5
    long?) tine? (day before bed) (what did most tired) most tense) (minutes) times, how most rest-
    total & 4 hrs you do?) long) ed)
    before bed)

    Example: 2pm, 40 2 coffees, 1 Nil. watched TV 3 - felt a bit 4 - felt very Read for 1 10:30pm 40 min 5:10am 6 hrs 40 Once at 3 - felt
    minutes beer, nothing after dinner, tired today tense when I hour min 2am, back somewhat
    after 4pm 3 hours went to bed to sleep rested when
    after 20 I woke up
    minutes

    This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at
    C entre for
    http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information.
    See website www.cci.health.wa.gov.au for more handouts and resources. CI linical
    nterventions
    •Psychotherapy•Research•Training

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