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Free Insomnia Screener · North Carolina Adults
Is Insomnia Affecting Your Life?
Quick Facts: Insomnia Screener (ISI)
- ✓ The ISI is a validated insomnia screening tool.
- ✓ It checks for severity of insomnia symptoms.
- ✓ It is not a diagnosis. A provider must evaluate you.
- ✓ Same-day insomnia evaluations are available at Pinnacle BHW.
The following screener is based on the Insomnia Severity Index (ISI). It is a validated tool used by clinicians worldwide to evaluate insomnia severity and impact. Rate each item based on your sleep experience over the last 2 weeks.
How Insomnia Screening Works
Insomnia is the most common sleep disorder in the United States. It affects an estimated 10–30% of the adult population. About 10% experience chronic insomnia that causes significant daytime impairment.
Despite how common it is, insomnia is frequently under-recognized and undertreated. Many people live with poor sleep for years without seeking help.
Chronic insomnia means difficulty falling asleep, staying asleep, or waking too early. It occurs at least three nights per week for three months or longer. It causes meaningful distress or functional impairment despite adequate opportunity for sleep.
Chronic insomnia is associated with increased risk of depression and anxiety. It also impairs cognitive function, reduces immune function, and leads to poorer physical health outcomes.
The good news is that insomnia is highly treatable. Evidence-based approaches such as CBT-I can significantly improve sleep quality and daytime functioning. Targeted medication management is also effective.
Common Sleep Problems This Test Flags
Insomnia is more than just a bad night of sleep. It is a pattern that repeats and affects how you think, feel, and function throughout the day.
In many cases, sleep problems are connected to anxiety, depression, stress, or trauma. These underlying concerns deserve their own evaluation and treatment.
Nighttime Symptoms
- •Trouble falling asleep despite feeling tired
- •Waking up multiple times during the night
- •Waking too early and unable to fall back asleep
- •Racing thoughts or worry at bedtime
- •Lying awake for long periods in the middle of the night
- •Non-restorative or poor-quality sleep
Daytime Symptoms
- •Fatigue or low energy despite being in bed
- •Difficulty concentrating or making decisions
- •Irritability, mood swings, or emotional sensitivity
- •Reduced performance at work or school
- •Anxiety about sleep itself ("sleep dread")
- •Dependence on naps or sleep aids
How the ISI Is Scored
The ISI uses a simple additive scoring system. Each of the 7 questions is scored from 0 to 4, for a maximum total of 28.
The ISI measures the severity of sleep-onset, sleep-maintenance, and early-morning awakening problems. It also assesses sleep satisfaction, daytime impairment, noticeability to others, and distress. Giving a comprehensive picture of how insomnia is affecting your life.
| ISI Score | Severity | Recommended Action |
|---|---|---|
| 0–7 | No clinically significant insomnia | Monitor; evaluate if concerns persist |
| 8–14 | Subthreshold insomnia | Improve sleep hygiene; consider evaluation |
| 15–21 | Moderate clinical insomnia | Professional evaluation recommended |
| 22–28 | Severe clinical insomnia | Full evaluation strongly recommended |
Scoring based on: Morin CM, Belleville G, Bélanger L, Ivers H. "The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response." Sleep, 2011;34(5):601-608.
Insomnia Screener (ISI)
Please rate the current (i.e., last 2 weeks) severity of your insomnia problem(s).
0 of 7 answered
1. Difficulty falling asleep
2. Difficulty staying asleep
3. Problems waking up too early
4. How satisfied/dissatisfied are you with your current sleep pattern?
5. How noticeable to others do you think your sleep problem is in terms of impairing the quality of your life?
6. How worried/distressed are you about your current sleep problem?
7. To what extent does your sleep problem interfere with your daily functioning (e.g., fatigue, mood, concentration, memory) currently?
This screener is based on the Insomnia Severity Index (ISI) developed by Dr. Charles M. Morin and colleagues. It is used for educational and informational purposes only. It is not a diagnostic tool. Sleep problems can be connected to anxiety, depression, trauma, ADHD, stress, medical concerns, and other conditions. A licensed provider performs a full clinical evaluation before any diagnosis or treatment plan is established.
Source: Morin CM, Belleville G, Bélanger L, Ivers H. "The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response." Sleep, 2011;34(5):601-608.
Why Mental Health and Sleep Are Deeply Connected
Sleep and mental health have a bidirectional relationship: poor sleep worsens mental health, and mental health conditions worsen sleep.
Anxiety is one of the most common causes of insomnia. Racing thoughts, worry, and hyperarousal make it nearly impossible for the nervous system to settle into restful sleep.
Depression disrupts sleep architecture, often causing early morning awakening. Sleep may feel non-restorative even when total hours in bed are adequate. ADHD is associated with delayed sleep phase and difficulty transitioning into sleep.
Trauma (PTSD) frequently causes hypervigilance, nightmares, and chronic sleep disruption. Many people with chronic insomnia have an undiagnosed or undertreated mental health condition driving the sleep problem. Which is why a psychiatric evaluation is often the most important first step.
When the underlying mental health condition is properly treated, sleep often improves significantly — sometimes dramatically. Addressing both sleep and mental health together leads to the best outcomes.
Frequently Asked Questions About Insomnia
How accurate is the Insomnia Severity Index (ISI)?
The ISI is one of the most widely validated insomnia screening tools available. The key validation study by Morin and colleagues (Sleep, 2011) showed excellent internal consistency and strong concurrent validity. It also demonstrated high sensitivity (97%) and specificity (90%) for detecting clinical insomnia cases. It is used in clinical practice and research worldwide. It is a screener — not a diagnosis — and results should be interpreted by a qualified healthcare provider.
What is the connection between insomnia and mental health?
Insomnia and mental health are closely bidirectionally linked. Anxiety, depression, PTSD, and ADHD are among the most common causes of chronic insomnia. At the same time, poor sleep worsens mood, cognitive function, emotional regulation, and resilience. Treating the underlying mental health condition often improves sleep. Treating the insomnia also helps mental health outcomes. A comprehensive psychiatric evaluation can identify which conditions are contributing to your sleep problems.
What is CBT-I and is it effective for insomnia?
CBT-I is widely considered the first-line treatment for chronic insomnia. Both the American Academy of Sleep Medicine and the American College of Physicians recommend it. CBT-I addresses the thoughts, behaviors, and habits that perpetuate insomnia. These include sleep restriction therapy, stimulus control, and cognitive restructuring. Research consistently shows CBT-I produces durable, long-term improvement in sleep that often outperforms medication alone.
When should insomnia be treated with medication?
Medication may be appropriate when insomnia is severe, when CBT-I has not been effective, or when insomnia is part of a broader psychiatric condition. Common options include non-benzodiazepine sleep aids, low-dose antidepressants with sedating properties, and melatonin receptor agonists. At Pinnacle BHW, medication decisions are made on an individualized basis by a licensed provider after a full evaluation.
Can telehealth help with insomnia treatment?
Yes — telehealth is well-suited for insomnia evaluation and treatment. Sleep history, mental health screening, and medication management can all be conducted via video appointment. Same-day telehealth appointments with our licensed psychiatric providers are often available for new patients across North Carolina. We accept most major insurance plans including Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Medicaid, and Medicare.
Related Resources
Ready to Get Help for Insomnia?
If insomnia or poor sleep affect your daily life, same-day psychiatric appointments are available across North Carolina via telehealth. We accept most major insurance plans including Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Medicaid, and Medicare.
Same-Day Appointments Available
Most patients seen within 24 hours • All major insurance accepted • Licensed providers