Tracking and your doctor
Printable night diary for hot flashes and sleep
Write down when you went to bed, how often you woke, every flush or sweat as mild, moderate or severe, and what you ate and drank that evening. After two weeks, you and your doctor can see the pattern in a minute.
The diary below is free. Fill in one row each morning on this page, or print a blank sheet and keep it by the bed. Your entries stay in this browser and are never sent to us, and the summary under the form counts what you logged without telling you what it means.
Why a night diary helps
The National Institute on Aging suggests taking note of what triggers your hot flashes and how much they bother you, because that helps you decide how to manage them. The same page names alcohol, spicy food and caffeine as things that can make symptoms worse. Without a record, a bad week blurs into "I never sleep", and the glass of wine on Tuesday is forgotten by Friday.
Sleep is the other half. The NIA's page on sleep problems and menopause notes that research suggests waking may itself set off a hot flash, rather than only the other way round. A diary that puts your wakings and your flushes on the same line lets you see which came first on your own nights. A sleep diary is also part of CBT for insomnia, the approach covered in our article on insomnia in menopause.
What goes in each row
The columns follow the sleep diary from the American Academy of Sleep Medicine, which covers two weeks and records when you went to bed, when you woke in the night, when you got up, and the timing of caffeine, alcohol, exercise, naps and medicines. I added three things that matter at night in midlife:
- how many hot flashes or night sweats you had, split by how bad they were
- the evening's spicy food and any large meal close to bedtime, next to alcohol and caffeine
- how rested you felt on getting up, in three plain words
Fill it in once, after you get up. Counting in the dark keeps you awake, and a morning estimate is accurate enough for a two-week pattern.
How to rate a flush or a sweat
Studies of hot flashes ask women to sort each one into three grades. A cohort study published in PLoS One in 2016 used these wordings, and the diary uses them too:
The night reading of "severe" is mine, so the grade fits a sleeping body rather than a working day. Whichever reading you choose, use the same one for all fourteen nights.
Your night diary
One row per night. Saving the same date again replaces that night.
Night diary: hot flashes, night sweats and sleep
No nights saved yet. Saved nights appear here as a table, and the printed sheet adds empty rows up to fourteen.
| Night of | Bed | Up | Woke | Mild | Moderate | Severe | Evening | Rested | Notes |
|---|
A worked example
Here is a made-up fortnight, to show how the summary reads. Over fourteen nights the diary holds 9 moderate and 4 severe flushes and 22 mild ones. Alcohol was ticked on four evenings. On those four nights the flushes add up to 14, an average of 3.5 a night. On the other ten nights they add up to 21, an average of 2.1.
The summary would report exactly those two averages and stop there. Four nights is a small sample, and wine often comes with a late dinner, so the diary cannot tell you which one mattered. What it gives you is a specific question to test next fortnight, or to take to an appointment: "on the nights I drank, I had more flushes, is that worth changing?"
My take
I'd start with the evening columns and judge the fortnight by them. They are the part you can change, memory loses them first, and they hold the triggers the NIA names. I'd skip trying to time each flush to the minute: a morning count by grade is what makes two weeks comparable.
Taking it to an appointment
Print your completed diary and take it with you. A doctor can read fourteen rows faster than a description, and the severity columns answer the question you will almost certainly be asked: how much are these affecting you? The NHS symptoms page says to see a GP if menopause symptoms are bothering you or you want to know your options, and the treatment choices are a conversation for that appointment.
If you would rather log on your phone, Her Good Days is a free app that keeps a dated log of menopause symptoms and sleep. You log each hot flash or night sweat as mild, moderate or severe with the time, add your bedtime, wake time, wake-ups and how rested you felt, and it shows how you slept on nights with night sweats compared with nights without. For an appointment it makes a PDF for the dates you pick, marked as reported by you. It has no paid plan, and its App Store and Google Play listings are coming soon.
When not to wait two weeks
Not every night sweat is caused by menopause. The NHS page on night sweats asks you to see a GP if they happen regularly and wake you or worry you, if you also have a high temperature, a cough or diarrhoea, or if you are losing weight without trying. Call the surgery for any of those now, and keep the diary going alongside.
Our guide to tracking symptoms for your doctor collects the articles on records and appointments. The night sweats page goes through the other causes in more detail.