Sleep diary

The sleep diary is the foundational data collection tool of CBT for Insomnia. The client logs one day at a time — when they got into bed, how long it took to fall asleep, how many times they woke, when they got out of bed, how rested they felt — and the practitioner reads the patterns at the weekly review. Rivet uses the Consensus Sleep Diary structure (Carney et al. 2012), which the sleep medicine field developed specifically to standardize sleep self-monitoring across research and clinical settings.

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What it captures

Fifteen fields, single-day entry.

• Date — defaults to today
• Time you got into bed — string (“23:30”)
• Time you fell asleep (estimate) — string
• How long it took to fall asleep (minutes) — integer (sleep onset latency)
• Number of times you woke during the night — integer
• Total time awake during those awakenings (minutes) — integer
• Time you woke up for the day — string
• Time you got out of bed — string
• Estimated total hours of sleep — decimal
• Sleep quality — 0-10 slider, very poor → very good
• How rested you felt today — 0-10 slider, exhausted → well rested
• Total daytime naps (minutes) — integer
• Caffeine after noon — boolean
• Alcohol in the evening — boolean
• Anything else worth noting — textarea, optional

No total score — the clinical signal is the pattern across many entries.

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What the practitioner reads

The fields are arranged to produce the variables CBT-I works with:

• Sleep onset latency (time-to-fall-asleep) — > 30 minutes is the insomnia threshold. The target of stimulus control and sleep restriction.
• Wake after sleep onset (WASO) — the awakening-minutes field. The target of sleep consolidation.
• Total sleep time vs time in bed — the ratio is sleep efficiency. ≥ 85% is adequate; < 80% is the insomnia threshold. Sleep restriction targets this ratio directly.
• Daytime impact — the rested rating captures whether the night translated into daytime function.
• Lifestyle factors — caffeine and alcohol entries surface obvious targets for sleep hygiene work without making the worksheet a generic habits checklist.

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When to use it

• CBT-I treatment. Daily for 1-2 weeks as baseline before any intervention, then ongoing during the active treatment phase.
• Insomnia screening. Two weeks of sleep diary alongside an ISI gives a much more reliable picture than ISI alone, because the diary captures the actual behavioral pattern rather than the client’s retrospective summary.
• Sleep symptoms in depression or anxiety treatment — the diary surfaces whether sleep is the maintenance mechanism worth targeting directly, or whether mood/anxiety improvement is dragging sleep along.
• PTSD with sleep symptoms — nightmares, frequent awakenings, and short total sleep are common in PTSD; the diary tracks whether trauma-focused treatment is reducing the sleep load.

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In-session mechanics

Templates → Sleep diary. Fifteen fields on one or two screens. You typically review prior responses (the client’s homework entries) by opening the Templates tab and looking at the response list, rather than filling new entries in-session — the daily fill is between-session homework. When reviewing, the most useful display is the per-day comparison. Open several recent responses in turn and scan onset latency, WASO, and sleep-efficiency-relevant numbers (bedtime vs out-of-bed-time, total sleep hours) to read the pattern.

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Citation

Carney, C. E., Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Krystal, A. D., Lichstein, K. L., & Morin, C. M. (2012). “The Consensus Sleep Diary: Standardizing prospective sleep self-monitoring.” Sleep, 35(2): 287-302. Buysse, D. J. (2008). “Insomnia.” JAMA, 309(7): 706-716. (Source for the sleep efficiency severity bands.) The Consensus Sleep Diary was published specifically to standardize the field; the structure is published clinical method and uncopyrightable. All field labels are original to Rivet.

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When not to use it

• Acute insomnia from a clearly identifiable transient cause. A bad week after a death, a job loss, or a medical event isn’t always chronic insomnia and doesn’t necessarily need the structured diary. Re-assess after 2-4 weeks.
• Severe sleep-disordered breathing suspected. Loud snoring, witnessed apneas, daytime sleepiness disproportionate to time in bed point at sleep apnea, which needs polysomnography and medical workup rather than CBT-I.
• Clients for whom self-monitoring drives anxiety about sleep. Performance anxiety about sleep is a sub-target of CBT-I; for some clients the daily diary itself makes the performance anxiety worse. Shorter-window monitoring (one week at a time, with breaks) can scaffold this.

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