About this tool
- •The ISI is a 7-item, free, validated insomnia screening tool used in clinical practice and research worldwide.
- •Each item is scored 0-4 (total range 0-28). Higher scores indicate more severe insomnia.
- •Cutoffs: 0-7 none, 8-14 subthreshold, 15-21 moderate clinical insomnia, 22-28 severe clinical insomnia.
- •Insomnia and mental health interact bidirectionally — insomnia worsens depression and anxiety, and depression and anxiety worsen insomnia. Treating both together is usually more effective than either alone.
- •Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment for chronic insomnia and works better than long-term sleep medication for most people.
- •For depression with co-occurring insomnia, antidepressant choice often considers sleep impact (sedating vs activating). Some patients respond best when both depression and insomnia are addressed together.
- •ISI was developed by Bastien, Vallières, and Morin (2001) and revalidated by Morin et al (2011). It is in the public domain.
Take the ISI
These questions ask about your sleep over the past 2 weeks. The ISI measures both the sleep difficulty itself and how much it is affecting your life.
0 of 7 answered
Your answers are processed in your browser. Nothing is saved or sent to anyone — including Tovani — until you choose to.
Frequently asked
How many hours of sleep should I be getting?
For most adults, 7-9 hours is healthy. But the ISI doesn't measure duration — it measures DIFFICULTY and IMPACT. You can sleep 7 hours but have severe insomnia if those hours are fragmented, unrefreshing, or accompanied by significant distress. Conversely, naturally short sleepers who feel rested aren't insomniac.
Should I just take sleep medication?
For chronic insomnia (3+ nights/week for 3+ months), CBT-I is more effective than long-term sleep medication for most people. Sleep medications can be useful short-term but often lose effectiveness over time and have side-effects. The exception: severe acute insomnia where medication helps bridge to longer-term treatment. Your clinician can help choose the right approach.
My insomnia is from depression/anxiety. What now?
Treating both together typically works better than either alone. Some antidepressants are sedating (mirtazapine, trazodone, low-dose doxepin) and help sleep directly. SSRIs/SNRIs can initially worsen sleep before improving it. CBT-I works regardless of whether depression or anxiety is also present. For treatment-resistant depression with severe insomnia, ketamine's rapid effect on mood often improves sleep as a side benefit.
Can ketamine help insomnia?
Ketamine isn't a primary insomnia treatment — but when severe insomnia is driven by depression or PTSD, ketamine's rapid antidepressant effect frequently improves sleep alongside the mood improvement. For insomnia without significant mood involvement, CBT-I and targeted sleep interventions are first-line.
I sleep fine on weekends but can't on weeknights. Does that count?
It might. The ISI asks about the past 2 weeks generally — if weeknight insomnia is causing distress and functional impact, you may still score in the clinically significant range. Schedule-related insomnia can respond well to behavioral interventions; mention the pattern to your clinician so they can target treatment.
References
- Murrough JW et al. 2013, American Journal of Psychiatry. Ketamine RCT in treatment-resistant depression — many TRD patients have severe co-occurring insomnia, and ketamine's rapid antidepressant effect often improves sleep alongside mood. PMID 23982301
- Sanacora G et al. 2017, JAMA Psychiatry. APA consensus on ketamine in mood disorders — relevant for patients with severe depression-insomnia comorbidity where standard treatments have not produced sufficient response. PMID 28249076