Insomnia Severity Index
Jennifer Daniels PhD, LCPCAccess Counseling Services, Inc.175 Olde Half Day Road, Suite 140-9, Lincolnshire IL 6006919 N. County Street Waukegan IL 60085(224)225-9650 | firstname.lastname@example.org
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' at the bottom of the Insomnia Severity Index page to see where your sleep difficulty fits. Print out a copy of your completed Insomnia Severity Index to take to your health care provider.
Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s).
1. Difficulty falling asleep
0 - None1 - Mild 2 - Moderate3 - Severe4 - Very Severe
2. Difficulty staying asleep
0 - None1 - Mild2 - Moderate3 - Severe4 - Very Severe
3. Problem waking up too early
4. How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?
0 - Very Satisfied1 - Satisfied2 - Moderately Satisfied3 - Dissastisfied4 - Very Dissatisfied
5. How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?
0 - Not at all Noticeable1 - A Little2 - Somewhat3 - Much4 - Very Much Noticeable
6. How WORRIED/DISTRESSED are you about your current sleep problem?
0 - Not at all Worried1 - A Little2 - Somewhat3 - Much4 - Very Much Satisfied
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?
0 - Not at all Interfering1 - A Little2 - Somewhat3 - Much4- Very Much Interfering
Add the scores for all seven items (questions 1 + 2 + 3 + 4 + 5 +6 + 7) = your total score
Total Score :
Total score categories:0-7 = No clinically significant insomnia8-14 = Subthreshold insomnia15-21 = Clinical insomnia (moderate severity)22-28 = Clinical insomnia (severe)
Print out your completed Insomnia Severity Index, along with the Guidelines for Scoring/Interpretation, to show to your health care provider.
Used with permission from Charles M. Morin, Ph.D., Université Laval
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