🌙 Sleep Assessment Suite
Comprehensive Sleep Health Evaluation
CBT-I Contraindication Screening
Please answer the following questions to determine if CBT-I is appropriate for you.
Do you have any of the following conditions? (Check all that apply)
Insomnia Severity Index (ISI)
Please rate the current severity of your insomnia problems.
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 do you consider your sleep problem to interfere with your daily functioning?
Pittsburgh Sleep Quality Index (PSQI)
Please answer the following questions about your sleep over the past month.
1. During the past month, what time have you usually gone to bed?
2. During the past month, how long (in minutes) has it taken you to fall asleep each night?
3. During the past month, what time have you usually gotten up in the morning?
4. During the past month, how many hours of actual sleep did you get at night?
5a. Cannot get to sleep within 30 minutes
5b. Wake up in the middle of the night or early morning
5c. Have to get up to use the bathroom
5d. Cannot breathe comfortably
5e. Cough or snore loudly
6. During the past month, how would you rate your sleep quality overall?
7. During the past month, how often have you taken medicine to help you sleep?
8. During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?
9. During the past month, how much of a problem has it been for you to keep up enthusiasm to get things done?
Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16)
Please indicate how much you agree with each statement (0 = strongly disagree, 100 = strongly agree)
1. I need 8 hours of sleep to feel refreshed and function well during the day
2. When I don't get the proper amount of sleep on a given night, I need to catch up on the next day by napping or on the next night by sleeping longer
3. I am concerned that chronic insomnia may have serious consequences on my physical health
4. When I have trouble sleeping, I should stay in bed and try harder
5. If I don't sleep well on a given night, I know it will interfere with my daily activities on the next day
6. In order to be alert and function well during the day, I believe I would be better off taking a sleeping pill rather than having a poor night's sleep
7. When I feel irritable, depressed, or anxious during the day, it is mostly because I did not sleep well the night before
8. When I sleep poorly on one night, I know it will disturb my sleep schedule for the whole week
9. Without an adequate night's sleep, I can hardly function the next day
10. I can't ever predict whether I'll have a good or poor night's sleep
11. I have little ability to manage the negative consequences of disturbed sleep
12. When I feel tired, have no energy, or just seem not to function well during the day, it is generally because I did not sleep well the night before
13. I believe insomnia is essentially the result of a chemical imbalance
14. I feel insomnia is ruining my ability to enjoy life and prevents me from doing what I want
15. Medication is probably the only solution to sleeplessness
16. I avoid or cancel obligations (social, family) after a poor night's sleep
📊 Complete Assessment Results
Complete all assessments to see your comprehensive results.