Download Sleep Log

This sleep log is used in cognitive-behavioral therapy for insomnia (CBT-I) treatment. It is very helpful for assessment of your sleep problem, and it also can be used to guide treatment and assess progress.

Instructions: Record your information across the page, in the boxes from left to right. Fill out the first set of boxes before you go to bed at night. Fill out the second set of boxes the next morning when you wake up. Dr. Loomis will fill in the boxes on the right side that say “complete in the office”.

The sleep log is meant to record your perception of your sleep, so your best guess is all we need. You don’t need to look at the clock or write anything down in the night. If completing the sleep log creates anxiety, you can discontinue it.