ISI Insomnia Severity Index [Outreach]

Insomnia Severity Index (ISI)

For each question, please choose the option that best describes your answer.
Please rate the CURRENT (i.e. last 2 weeks) SEVERITY of your insomnia problem: Difficulty falling asleep*

NoneMildModerateSevereVery Severe
Please rate the CURRENT (i.e. last 2 weeks) SEVERITY of your insomnia problem: Difficulty staying asleep*

NoneMildModerateSevereVery Severe
Please rate the CURRENT (i.e. last 2 weeks) SEVERITY of your insomnia problem: Waking up too early*

NoneMildModerateSevereVery Severe
How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?*

Very SatisfiedSatisfiedModerately SatisfiedDissatisfiedVery Dissatisfied
How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?*

Not at all NoticeableA LittleSomewhatMuchVery Much Noticeable
How WORRIED/DISTRESSED are you about your current sleep problem?*

Not at all WorriedA LittleSomewhatMuchVery 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?*

Not at all InterferingA LittleSomewhatMuchVery Much Interfering
How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?

Very SatisfiedSatisfiedModerately SatisfiedDissatisfiedVery Dissatisfied
How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?

Not at all NoticeableA LittleSomewhatMuchVery Much Noticeable
How WORRIED/DISTRESSED are you about your current sleep problem?

Not at all WorriedA LittleSomewhatMuchVery 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?

Not at all InterferingA LittleSomewhatMuchVery Much Interfering
How does your sleep problem affect you during the day? Select all that apply.

Difficulty ConcentratingExcessive FatigueMood Issues (feeling anxious, depressed, or irritable)Affects Relationships with loved onesImpaired Performance at Work
Age Group*
Sex*

MaleFemale
Name*

First NameLast Name
Email*
Enter your personal email for the results to be sent to you
Date*

DayMonthYear
Source*
Corporate Name
Management Level
Select the most appropriate level.
ISI Score
0-24
ISI Report
No clinically significant insomnia
0-7: You do not currently have symptoms of insomnia. 

Keep up the good work and try to get 7-9 hours of sleep as often as possible!0-7
Subthreshold insomnia
8-14: You currently have some symptoms of insomnia, although these are not in the clinical range. 

Lifestyle adjustments such as exercising more and managing your stress may help to reduce these symptoms. You may also consider undergoing cognitive-behavioural therapy for insomnia (CBT-I), especially if your symptoms are bothersome. 

If you'd like to find out more about our individual and group CBT-I programmes, contact us for a free phone consultation.8-14
Clinical insomnia (moderate)
15-21: You currently have moderate symptoms of insomnia, and it’s likely that these are affecting your daytime functioning and quality of life. 

We recommend that you seek help for the problem. Cognitive-behavioural therapy for insomnia (CBT-I) is very effective for most people, and clients usually see improvements within a few weeks. 

If you'd like to find out more about our individual and group CBT-I programmes, contact us for a free phone consultation.15-21
Clinical insomnia (severe)
22-28: You currently have severe symptoms of insomnia, and it’s likely that these are affecting your daytime functioning and quality of life. 

We strongly recommend that you seek help for the problem. Cognitive-behavioural therapy for insomnia (CBT-I) is very effective for most people, and clients usually see improvements within a few weeks. 

If you'd like to find out more about our individual and group CBT-I programmes, contact us for a free phone consultation.22-28
This information collected will solely be used for transmitting the results of the screening with brief recommendations to you.
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Insomnia Severity Index (ISI)