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Please Answer All Questions
The Insomnia Severity Index has seven questions. The seven answers are added up to get a total score. Please use the scale that follows the questions to determine your score.
Please rate the CURRENT (LAST 2 WEEKS) SEVERITY of your insomnia problem. Use the information at the bottom of the form to determine your score.
Use the following scale to determine your score:
- Score 0 if you answered None, Very Satisfied or Not at all
- Score 1 if you answered Mild, Satisfied or A little
- Score 2 if you answered Moderate, Moderately Satisfied or Somewhat
- Score 3 if you answered Severe, Dissatisfied or Much
- Score 4 if you answered Very Severe, Very Dissatisfied or Very much