80% of insomnia complaints can be traced to physiological problems or to poor sleep habits.
The purpose of this questionnaire is to help assess your complaints of insomnia, to rule out other possible causes of your symptoms, and to assess the need for a sleep study.
Generally, if you are not tired during the day, you don’t have insomnia. The following scale will help you assess your answers:
If you answered yes to 5 or more questions, there is a high probability that you may have insomnia or another sleep disorder. See your Primary Care Physician (PCP) for a referral to a sleep laboratory.
If you answered yes to 3-5 questions, you may have insomnia or another sleep disturbance. See your PCP and discuss your symptoms.
If you answered yes to 3 or fewer questions, there is a low likelihood of insomnia or other sleep problems. See your PCP to review your sleep habits and complaints.