Health Zone Insomnia Symptoms (ISI) Insomnia Symptoms (ISI) Please rate the CURRENT SEVERITY (i.e., LAST 2 WEEKS) of your insomnia problems in relation to difficulties falling asleep. ---- None Mild Moderate Severe Very Severe Please rate the CURRENT SEVERITY (i.e., LAST 2 WEEKS) of your insomnia problems in relation to difficulties staying asleep. ---- None Mild Moderate Severe Very Severe Please rate the CURRENT SEVERITY (i.e., LAST 2 WEEKS) of your insomnia problems in relation to difficulties in waking too early. ---- None Mild Moderate Severe Very Severe How SATISFIED/DISSATISFIED are you with yout CURRENT sleep pattern? ---- Very Satisfied Moderately Satisfied Satisfied Dissatisfied Very Dissatisfied 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 How WORRIED/DISTRESSED are you about your current sleep problem? ---- Not at all worried A little Somewhat Much Very much worried To what extend 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 GET FEEDBACK © 2024 HealthZone Disclaimer & Copyright Terms of Use Privacy Statement Contact Us Crisis Support Information
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