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ISI

Please rate the current (i.e. last 2 weeks) severity of your insomnia problem(s).

1. 1.Difficulty falling asleep.

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

2. 2.Difficulty staying asleep.

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

3. 3.Problem waking up too early.

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

4. 4.How satisfied/dissatisfied are you with your current sleep pattern?

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

5. 5.How noticeable to others do you think your sleep problem is in terms of impairing the quality of your life?

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

6. 6.How worried/distressed are you about your current sleep problem?

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe

7. 7.To what extent do you consider your sleep problem to interfere with your daily functioning?

   • [0]None
   • [1]Mild
   • [2]Moderate
   • [3]Severe
   • [4]Very severe