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Insomnia Severity Index Assessment
Assess insomnia online with the 7-item ISI, review score bands and top symptom drivers, compare a prior total, and export a clear follow-up record.Severity snapshot
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Assessment result details
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Share result
Share this result page with someone you trust to review your answers and result.
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Severity gauge
Item severity map
What this result suggests
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The gauge keeps the official ISI total on the original 0 to 28 scale. Use it with the band boundary notes and item review below; the ISI is interpreted as one screening score rather than a set of official subscales.
Cutoff and boundary context
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Highest-scored items
These items are carrying the most weight on this run. They are practical review cues, not official ISI subscales.
Recommended next actions
The item severity map keeps every ISI item on the original 0 to 4 scale so higher-intensity contributors and lower-intensity anchors stay visible in one place.
Suggested next steps
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Monitor
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Bring into follow-up
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Seek support sooner if
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Higher/lower item focus
ISI is interpreted as one total score. This comparison only shows which prompts were more or less endorsed on this run.
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Answer review
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Introduction:
Insomnia is a pattern of trouble falling asleep, staying asleep, or waking earlier than intended that starts to matter because the next day is harder to get through. The Insomnia Severity Index, usually called the ISI, turns that recent burden into one short score by asking about the last 2 weeks instead of one unusually good or bad night.
That short score is useful because sleep complaints can look similar from the outside while leading to very different daily consequences. One person may mainly lie awake at the start of the night. Another may wake repeatedly and feel functional loss the next day. A third may feel most burdened by dissatisfaction with sleep or by worry about the problem itself. The ISI keeps those experiences on one 0 to 28 scale so the overall burden is easier to compare over time.
This assessment keeps the published four-band reading at the center of the result, then adds practical cues around it. It highlights which items scored highest, shows how close the total is to the next band boundary, and can compare the current total with a prior total from an earlier check-in. Those extras do not change the official score. They help explain what is carrying the result on this run.
An ISI result is still a screening result, not a diagnosis and not an explanation of cause. Chronic insomnia is usually defined over a longer pattern than 2 weeks, and sleep problems can also reflect pain, medication effects, mood symptoms, breathing-related sleep disorders, shift work, or other medical issues. If sleep loss is affecting work, concentration, mood, or driving safety, direct clinical follow-up matters more than any self-screen.
Technical Details:
The ISI uses seven scored items, each rated from 0 to 4. Three items cover night symptoms: difficulty falling asleep, difficulty staying asleep, and waking too early. The remaining items cover satisfaction with the current sleep pattern, daytime interference, how noticeable the problem feels, and how worried or distressed the person feels about sleep. Adding those seven answers produces the familiar total from 0 to 28.
This assessment does not reverse-score any item, does not estimate missing answers, and does not produce a result until all seven responses are present. The official reading remains the total score and its published band. The extra summaries in the result panel are tool-specific reading aids built from the same answers.
The total score is the sum of the seven item ratings:
Here T is the current ISI total from 0 to 28, each x value is one answer from 0 to 4, and Δ is the optional change from a prior total if you enter one in the completed result. That comparison is descriptive only. It never changes the current score band.
| Score range | Band | How to read it |
|---|---|---|
| 0 to 7 | No clinically significant insomnia | Recent insomnia burden is low on this questionnaire. |
| 8 to 14 | Subthreshold insomnia | Symptoms are present, but the total stays below the clinical bands. |
| 15 to 21 | Clinical insomnia, moderate severity | The reported burden has moved into a clearly clinical range on the ISI. |
| 22 to 28 | Clinical insomnia, severe | The questionnaire is describing the highest published severity band. |
| Result part | What it uses | What it means here |
|---|---|---|
| Total score | All seven items added together | The official ISI result used for the main band and severity gauge. |
| Cutoff context | Current total and the nearest published boundary | Shows how far the score sits below or inside the next band threshold. |
| Top area | Night symptoms, sleep appraisal, day impact, or distress | Summarizes where the current burden is most concentrated on this run. |
| Highest-scored items | The most strongly endorsed individual prompts | Helps focus follow-up without turning the ISI into official subscales. |
| Support urgency | Band plus day-impact, distress, trend, and safety context | Offers tool-defined follow-up wording. It is not part of the published ISI instrument. |
Boundary reading matters. A score of 14 and a score of 15 are separated by only one point, but they fall into different published bands. That is why the result shows both the band and the distance from the next cutoff. The optional review focus does not alter any of this math. It only changes the wording of the suggested follow-up section for routine self-checks, CBT-I or behavior follow-up, clinician discussion prep, or work and safety review.
Everyday Use & Decision Guide:
The cleanest reading comes from answering for your usual pattern across the last 2 weeks. If you score right after a red-eye flight, a night shift stretch, an illness, or one unusually bad night, the number can still be real for that moment, but it may not describe your usual burden very well. When you want a baseline, wait for a more typical 2-week window.
Start with the total and band before reading any of the extra cues. After that, look at the cutoff note, the highest-scored items, and whether the result is being pulled more by night symptoms, daytime effects, or distress. That order keeps the published ISI reading first while still making room for the richer profile that this assessment builds around it.
The optional review focus is best treated as a communication aid. A routine self-check, CBT-I follow-up, clinician visit, and work-or-safety review can all use the same ISI total, but the questions you bring into follow-up are different. The focus setting helps tailor those next-step prompts without moving the score, the band, or the charts.
- If the total is near 8, 15, or 22, read the cutoff note carefully before assuming the label change reflects a major shift in day-to-day life.
- If daytime interference, noticeability, or distress is scoring high, bring concrete examples from work, school, mood, concentration, or driving into follow-up instead of talking only about bedtime.
- If you are repeating the assessment, compare only complete ISI runs that used the same 2-week recall window and similar real-world context.
Step-by-Step Guide:
- Select Begin Assessment and answer each prompt for the last 2 weeks, using your usual sleep pattern rather than one standout night.
- Work through all seven items. If the results do not appear, open the item navigator and finish any prompt that does not show a completed check mark.
- Read the ISI Severity Snapshot first. That gives you the total score, published band, top area, urgency cue, and any prior-score trend note.
- Open Cutoff and boundary context next so you can see how close the score is to the next published threshold.
- Review Highest-scored items, the ISI Item Severity Map, and the recommended actions to see whether the burden is concentrated in night symptoms, daytime effects, or distress.
- If you want follow-up context, open Advanced to add a review focus, a previous ISI total, and the number of weeks since that earlier score. Use the response ledger, structured record, or chart exports if you need something to save or share.
Interpreting Results:
The main question is how heavy the recent insomnia burden looks on this questionnaire. A lower score means fewer or less intense reported problems over the last 2 weeks. A higher score means the burden is broader, stronger, or both. What the number does not tell you is why sleep is difficult. Cause still depends on history, daytime symptoms, other medical conditions, medication use, and the possibility of other sleep disorders.
Use the band and the cutoff note together. A score of 8 is already in the subthreshold range, but it sits just one point above the 0 to 7 band. A score of 15 enters the clinical moderate band, but it is only one point above 14. Near those edges, the label can change faster than the lived experience. The cutoff note helps you see whether the result is barely across a boundary or well inside a range.
| Pattern | What to verify before acting on it |
|---|---|
| Lower total with one clearly high night item | Check whether the problem is concentrated in sleep onset, middle-of-the-night waking, or early waking instead of treating the whole sleep pattern as equally affected. |
| Subthreshold total with strong daytime interference or distress | Look beyond the band and verify how much the sleep problem is affecting work, concentration, mood, or safety. |
| Moderate or severe total with several items at 3 or 4 | Assume the burden is broad rather than tied to one symptom and bring the result into structured follow-up. |
| Same total as before but different highest-scored items | Compare the item map and top items, not only the overall score, because the pattern of burden may have shifted. |
A low result should not create false reassurance if daytime impairment is real or if another sleep problem may be present. A high result should not create false certainty that the cause is insomnia alone. If the number and your real-life experience do not match, verify the answer pattern, keep a sleep diary for a week or two, and bring both into follow-up. That mismatch is a clue, not a reason to dismiss either the questionnaire or your symptoms.
The urgency cue in this assessment is best read as a practical nudge, not as a diagnosis. It becomes more urgent when the band is higher, when daytime impact or distress is strong, when the score is worsening, or when you are using the result for work or driving safety review. In those situations, direct human follow-up matters more than trying to manage the result as a private tracking number.
Worked Examples:
Borderline entry into the subthreshold band
Suppose the item scores are 2, 1, 1, 1, 1, 1, and 1. The total is 8, which places the result in the subthreshold range, but only one point above the 0 to 7 band. In that situation, the label changed, yet the cutoff note would show that the score is still far below 15. The next step is usually to see which item is pulling hardest, keep the same 2-week frame, and recheck if the pattern persists.
Moderate score with broad daytime burden
Now imagine scores of 3, 2, 2, 3, 3, 2, and 3. The total becomes 18, which is in the clinical moderate range. This is not just a bedtime problem. The day-impact items and distress item are also high, so the most useful follow-up would include concrete examples from concentration, mood, work, or driving rather than talking only about trouble falling asleep.
Same total, different pattern
Two runs can both total 14 and still point to different conversations. One run might be driven mostly by difficulty falling asleep and early waking. Another might show milder night symptoms but more dissatisfaction and stronger daytime interference. The band did not change, yet the highest-scored items changed, so the follow-up question changed too.
Troubleshooting a one-point band change
A move from 14 to 15 changes the published band from subthreshold to clinical moderate, which can feel more dramatic than the lived change really was. The corrective path is to read the cutoff note, check whether the same 2-week frame was used both times, and compare the highest-scored items before assuming the sleep problem worsened sharply.
FAQ:
Does this diagnose chronic insomnia?
No. It scores a 2-week self-report screener. Chronic insomnia is usually diagnosed over a longer pattern, and diagnosis also depends on daytime impact, medical history, and whether another sleep or health problem may be involved.
Why can the score stay the same while the advice changes?
Because the total score and band are only part of the picture. This assessment also looks at which items scored highest, whether the burden is leaning toward daytime impact or distress, and which review focus you selected. Those cues can change follow-up wording even when the total stays the same.
Why am I not seeing a result yet?
The assessment waits for all seven answers before it calculates the total or draws the charts. If the result panel does not appear, return to the item list and finish any prompt that does not show a completed check mark.
Can I compare this with an older ISI score?
Yes, if the earlier number came from another complete ISI taken over the same 2-week recall window. The previous-score field is helpful for direction of change, but it is weaker if the older number came from memory or from a very different real-world context.
Are my answers sent to a server?
Routine scoring stays in the browser. The main privacy caution is that saved links and exported records can preserve completed response data, so treat them as personal health information if the result is sensitive.
Glossary:
- ISI
- The Insomnia Severity Index, a seven-item self-report measure of recent insomnia burden.
- Subthreshold insomnia
- The published ISI band from 8 to 14, where symptoms are present but the total stays below the clinical bands.
- Cutoff context
- A note showing how close the current total is to the nearest published score boundary.
- Day impact
- This assessment's summary of the daytime interference and noticeability items.
- CBT-I
- Cognitive behavioral therapy for insomnia, a structured non-drug treatment commonly recommended for persistent insomnia.
References:
- Validation of the Insomnia Severity Index as an outcome measure for insomnia research, Sleep Medicine, 2001.
- Insomnia Severity Index protocol, PhenX Toolkit.
- The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response, Sleep, 2011.
- Insomnia diagnosis, National Heart, Lung, and Blood Institute.
- Insomnia treatment, National Heart, Lung, and Blood Institute.