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Sleep Diary Period Template

A plain sleep diary for bedtime, wake time, wake-ups, daytime sleepiness, period day, cramps, bleeding, night sweats, context notes, and clinician questions.

Bad sleep can blur together fast.

You may remember one awful night. You may forget the dates. This diary helps you put sleep notes next to period notes. It does not tell you the cause. It does not give sleep treatment.

Use paper, a note app, a spreadsheet, or Floriva. Keep only what helps.

Start here

Fill this in before you start the daily log.

Field Your notes Date range Last period start date Usual cycle length, if known Main sleep concern Worst time of night falling asleep / wake ups / early wake / other Main daytime problem sleepy / foggy / mood / pain / work / care tasks Main period symptom cramps / bleeding / sweats / mood / other Main question for care

If you do not know cycle day, use plain timing. Try "3 days before bleeding" or "period day 2."

Daily sleep and period diary

Fill this out in the morning.

Date Cycle or period day Bedtime Wake time Wake ups Sleep felt Daytime sleepiness Bleeding Cramps Night sweats Notes : good / okay / poor low / medium / high none / spotting / light / medium / heavy none / mild / strong no / damp / soaked

Short notes are enough.

"Up three times with cramps." "Damp shirt at 4 AM." "Heavy flow, slept on towel." "Very sleepy at school." "Could not drive the next morning."

Context notes

Use this only when it matters.

Date Medicine note Caffeine note Alcohol note Stress or travel note Other context name or change, if relevant none / morning / afternoon / evening none / some

Do not turn this into a rule sheet. One row cannot prove that caffeine, alcohol, medicine, stress, or your period caused poor sleep.

Pattern check

Answer these after one week or one cycle.

Question Your notes Which nights were worst? Did poor sleep show up before bleeding? Did poor sleep show up during bleeding? Did poor sleep ease after bleeding? Which symptom showed up with poor sleep? How did sleepiness affect the next day? What do you want help with first?

If the pattern is not clear, write that. "No clear pattern" is useful.

Questions for a clinician

Pick the questions that fit.

Does this timing look cycle linked? What other sleep causes should we check? Should I keep a sleep diary for another cycle? Do cramps, bleeding, or night sweats need review too? Could medicine or another health issue affect sleep? What symptoms mean I should call sooner? Do you want the full diary or a short summary? What should I track before the next visit?

MedlinePlus suggests bringing questions and symptom notes to a visit. Keep your list short enough to use in the room.

Short visit script

Use this if you do not want to hand over the full diary.

"I tracked sleep and period timing from to . My worst sleep happened . I also had . The next day problem was . I want help figuring out what to check next."

You can bring this with the period sleep visit prep worksheet. For a shorter handoff, use the sleep and period symptom summary. If falling asleep is the main issue, use the can't sleep before period notes.

Privacy note

Sleep notes can include medicine, alcohol, mood, work, location, sex, pregnancy worries, and period details.

Before you share, ask:

Does this person need the full diary? Can I share a one page summary? Can I remove names or private notes? Will this go into a portal, email, or download folder? Do I want to keep a copy of what I sent?

Read the sleep cycle data privacy checklist before you export more than you need. For care prep, read Floriva for gynecologist prep.

If food or bowel symptoms are part of the same week, use the food and cycle symptom diary.