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Insomnia Severity Index The Insomnia Severity Index has seven questions. The seven answers are added up to get a total score. When you have your total score, look at the 'Guidelines for Scoring/Interpretation' below to see where your sleep difficulty fits. For each question, please CIRCLE the number that best describes your answer. Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s). Insomnia Problem
None
Mild
Moderate
Severe
Very Severe
1. Difficulty falling asleep
0
1
2
3
4
2. Difficulty staying asleep
0
1
2
3
4
3. Problems waking up too early
0
1
2
3
4
4. How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern? Very Satisfied Satisfied Moderately Satisfied Dissatisfied 0 1 2 3
Very Dissatisfied 4
5. How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life? Not at all Noticeable A Little Somewhat Much Very Much Noticeable 0 1 2 3 4 6. How WORRIED/DISTRESSED are you about your current sleep problem? Not at all Worried A Little Somewhat Much Very Much Worried 0 1 2 3 4 7. To 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? Not at all Interfering A Little Somewhat Much Very Much Interfering 0 1 2 3 4
Guidelines for Scoring/Interpretation: Add the scores for all seven items (questions 1 + 2 + 3 + 4 + 5 +6 + 7) = _______ your total score Total score categories: 0–7 = No clinically significant insomnia 8–14 = Subthreshold insomnia 15–21 = Clinical insomnia (moderate severity) 22–28 = Clinical insomnia (severe)
Used via courtesy of www.myhealth.va.gov with permission from Charles M. Morin, Ph.D., Université Laval
