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Sleep Diary

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Personal Sleep Diary

The more information your healthcare professional has about your sleeping patterns and habits, the easier it will be to diagnose and treat your problem. It can provide information to supplement any other information about your condition you share with your healthcare professional.

This 7-day Sleep Diary will give you a clear "snapshot" of your sleep patterns to share with your healthcare professional.

Keep a record of your sleep

It's easy. Just answer the questions in the morning and before bed for 7 consecutive days and nights. The Sleep Diary tool will create a picture of your sleep patterns over the week.

Looking at your Diary, you may see patterns that will give you insight into your sleep habits. The Diary may also help your healthcare professional to determine the best treatment for you, so be sure to print it out and take it with you on your next visit.

Download Sleep Diary (PDF)

Note: The diary is provided in Adobe® Acrobat® Reader® format (PDF). To view or print it, you must have Adobe Acrobat Reader (version 3.0 or higher) installed on your computer. If you do not have the Reader, you can obtain it free from Adobe Systems Incorporated. Click on the icon below to download the program from their Web site.

Adobe

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† Maximum benefit is $240 off, up to $20 off each prescription (up to 12 prescriptions), depending on your out-of-pocket costs. Not valid for patients participating in Medicare, Medicaid, government (public insurance) programs, or any private payor in the state of Massachusetts and where prohibited by law.
‡ See terms and conditions on offer material.

AMBIEN CR is indicated to help you fall asleep and/or stay asleep.

AMBIEN is indicated for short-term treatment to help you fall asleep.

IMPORTANT SAFETY INFORMATION

AMBIEN and AMBIEN CR are treatment options you and your doctor can consider along with lifestyle changes. When taking either of them, don’t drive or operate machinery. Plan to devote 7 to 8 hours to sleep before being active. Sleepwalking, and eating or driving while not fully awake, with memory loss for the event, as well as abnormal behaviors such as being more outgoing or aggressive than normal, confusion, agitation, and hallucinations may occur. Don’t take it with alcohol as it may increase these behaviors. In patients with depression, worsening of depression, including risk of suicide may occur. If you experience any of these behaviors contact your doctor immediately. Allergic reactions such as shortness of breath, swelling of your tongue or throat, may occur and in rare cases may be fatal. If you have an allergic reaction while using AMBIEN or AMBIEN CR, contact your doctor immediately. Side effects of AMBIEN CR may include next-day drowsiness, dizziness and headache. There is a low occurrence of side effects associated with the short-term use of AMBIEN. The most commonly observed side effects in controlled clinical trials were drowsiness, dizziness, and diarrhea. AMBIEN is taken for 7 to 10 days –or longer as advised by your provider. AMBIEN CR can be taken as long as your doctor recommends. AMBIEN and AMBIEN CR have some risk of dependency. They are non-narcotic.

Please refer to the AMBIEN CR full prescribing information and medication guide.
Please refer to the AMBIEN full prescribing information and medication guide.

Click here for information on drug anti-counterfeiting.

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