Sleep Diary

If your child has a sleep problem, collect the following information for 3 nights before you make an initial or follow-up appointment. This information will be very useful for designing an appropriate treatment plan.

Morning Awakening (Time):

Nap 1

1. Asleep at (time):
2. What you did:

3. How long your child slept (minutes):

    

Nap 2

1. Asleep at (time):
2. What you did:

3. How long your child slept (minutes):

Evening Bedtime

1. Asleep at (time):
2. How long it took to go to sleep (minutes):
3. What you did:

Night Awakening 1

1. Awake at (time):
2. How long your child was awake (minutes):
3. What you did:

Night Awakening 2

1. Awake at (time):
2. How long your child was awake (minutes):
3. What you did: