"Sleep Diary Template for a Child"

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Download "Sleep Diary Template for a Child"

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Sleep Diary
Name:
___________________________________________________________________________
Monday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Tuesday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Wednesday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Thursday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Friday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Saturday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up? [Circle one number choice]
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Sunday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
www.FreePrintableMedicalForms.com
Sleep Diary
Name:
___________________________________________________________________________
Monday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Tuesday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Wednesday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Thursday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Friday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Saturday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up? [Circle one number choice]
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
Sunday
1. Time I went to sleep____________ Time I woke up ______________Total sleep time____________
2. How did I feel when I woke up?
Wide awake and ready for the day!
Awake, but feeling a little tired.
I want to go back to sleep…
1
2
3
4
5
www.FreePrintableMedicalForms.com