Insomnia Severity Index
The Insomnia Severity Index has seven questions. The seven answers are added up to get a total score. For each question, please SELECT the number that best describes your answer.
Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomniaproblem(s).
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Rows
None
Mild
Moderate
Severe
Very Severe
Difficulty falling asleep
Difficulty staying asleep
Problems waking too early
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Rows
Very satisfied
Satisfied
Moderately
Dissatisfied
Very Dissatisfied
How SATISFIED/DISSATISFIED are you with your CURRENT sleep patern?
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Rows
Not at all
A little
Somewhat
Much
Very Much
How NOTICEABLE to others do you think your sleep problem is in terms of impairing your quality of life?
How WORRIED / DISTRESSED are you about your current sleep problem?
What extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY?
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