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  1. sleepeducation.org › docs › default-document-libraryTWO WEEK SLEEP DIARY

    TWO WEEK SLEEP DIARY INSTRUCTIONS: (1) Write the date, day of the week, and type of day: Work, School, Day Off, or Vacation. (2) Put the letter “C” in the box when you have coffee, cola or tea. Put “M” when you take any medicine. Put “A” when you drink alcohol. Put “E” when you exercise.

  2. INSTRUCTIONS: TWO WEEK SLEEP DIARY 1. Write the date, day of the week, and type of day: Work, School, Day Off, or Vacation. 2. Put the letter “C” in the box when you have coffee, cola or tea. Put “M” when you take any medicine. Put “A” when you drink alcohol. Put “E” when you exercise. 3. Put a line (l) to show when you go to bed.

  3. Stanford Sleep Health and Insomnia Program: Two Week Sleep Diary Adapted from the American Academy of Sleep Medicine. Write the date, day of the week, and type of day: Work, School, Day Off, or Vacation.

  4. TWO WEEK SLEEP DIARY. INSTRUCTIONS: Write the date, day or the week and type of day: (W)ork, (S)chool, (O)ff or (V)acation. Put the letter “C” in the box when you have any caffeinated beverage or supplement that includes caffeine. Put “M” when you take ANY Medication. Put “A” when you drink alcohol. Put “E” when you exercise.

  5. Two-Week Sleep Diary. This tool is intended to help you keep track of your sleeping habits. Make sure you share this information with your healthcare provider. Together, you can review your progress and make sure you’re getting the most out of your treatment plan. Dayb/ Type Date of Day.

  6. ADULT TWO WEEK SLEEP DIARY INSTRUCTIONS: 1. Write the date, day of the week, and type of day: Work, Off, School, or Vacation. 2. Put the letter “C” in the box when you have caffeine. Put “M” when you take any medicine. Put “E” when you exercise. Put “A” when you drink alcohol. 3. Put a line (|) to show when you went to bed.

  7. TWO WEEK SLEEP DIARY. INSTRUCTIONS: Write the date, day of the week and type of day (Work, School, Day Off or Vacation) Put the letter "C" in the box when you have coffee, cola or tea. Put "M" when you take any medicine. Put "A" when you drink alcohol. Put "E" when you exercise. Put a line "|" to show when you go to bed.

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