Insomnia Severity Index

INSOMNIA SEVERITY INDEX
Instructions:

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 check the box next to the number that best describes your answer. Please rate the current (i.e. last two weeks) severity of your insomnia problem(s).
Difficulty falling asleep:*

0 = None1 = Mild2 = Moderate3 = Severe4 = Very Severe
Difficulty staying asleep:*

0 = None1 = Mild2 = Moderate3 = Severe4 = Very Severe
Problems waking up too early:*

0 = None1 = Mild2 = Moderate3 = Severe4 = Very Severe
How satisfied/dissatisfied are you with your current sleep pattern?*

0 = Very Satisfied1 = Satisfied2 = Moderately Satisfied3 = Dissatisfied4 = Very Dissatisfied
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
How worried/distressed are you about your current sleep problem?*

0 = Not at all Worried1 = A Little2 = Somewhat3 = Much4 = Very Much Worried
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
Total Score:
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