In the February, 2012 issue of Sleep, Colleen Carney and a group of sleep specialists completed the 7 year task of generating a standard sleep diary and instructions for the assessment of insomnia. Actually they generated 2 forms, a short form completed daily in the morning and a long form completed daily in the morning and at bedtime. The diary formats were also evaluated in a series of focus groups made up of good sleepers, insomnia sufferers, and sleep apnea patients to get their opinions regarding optimal content, wording, and format of the items of the diary.
The short form is formatted to collect a week of data on a single page and allows the clinician to calculate the sleep parameters that are most salient to the assessment and treatment of insomnia: sleep onset latency, wake time after initial sleep onset, total sleep time, total time spent in bed, and sleep efficiency (the percent of time spent asleep out of the time in bed). There is also a rating scale for the quality of the night’s sleep. The standardization also creates a uniformity of definition of these parameters, replacing the multitude of forms which have been generated by various sleep labs and clinicians. The long form collects a week of data on 2 pages and adds information regarding daytime napping, alcohol and caffeine consumption, medication usage, and a rating of the restfulness of sleep.
Since a nocturnal polysomnograph is not recommended in the assessment of insomnia, the sleep diary has long been considered the gold standard of insomnia assessment. The sleep diary is akin to the thought log that is widely used in cognitive behavioral psychotherapy. Disturbed sleep is a prominent symptom associated with psychological distress and there are simple and effective interventions for insomnia, which makes the sleep diary an essential component in the initial assessment and treatment planning process.