Your Sleep DiaryFill in each day so we can keep a record of your progress and make any necessary adjustments to your plan CBT-I Sleep Diary Submit one entry per day. * = required. Leave this blank Client name* Client email* Date of diary* Time you attempted to fall asleep* Minutes to fall asleep* Number of awakenings* Total minutes awake during the night (WASO)* Time of final awakening* Time you got out of bed for the day* Did you nap yesterday?* Select… Yes No Nap details (if yes) Caffeine after 2pm 0123+ Alcohol yesterday evening (units) 0123+ Medication or supplements for sleep Sleep quality (1=very poor, 5=very good) Stress/anxiety at bedtime (0–10) Anything else to note I consent to this information being used for sleep coaching. * Submit diary
