Insomnia Self-Check Questionnaire for Evaluating Sleep Issues and Daytime Impact

Insomnia Self-Check

This checklist helps you learn how your recent sleep experiences match DSM-5-TR features of Insomnia Disorder.
Not a diagnosis.
Past 3 months: For each statement, pick how often it applies.
0 = Never / 0 nights  |  1 = Sometimes (1–2 nights/week)  |  2 = Often (3–4 nights/week)  |  3 = Almost always (5–7 nights/week)
Crisis? Call 988 (U.S.) or go to the nearest ER.

Night-time Sleep Problems

  • 1. I couldn’t fall asleep within 30 minutes of getting into bed.
  • 2. I woke up during the night and then lay awake for a long time.
  • 3. I woke up earlier than I needed and couldn’t get back to sleep.

Daytime Impact & Distress

  • 4. I felt tired or low-energy during the day because of poor sleep.
  • 5. Lack of sleep made it hard to focus or get things done at work, school, or home.
  • 6. I was irritable, anxious, or down because I hadn’t slept well.
  • 7. I worried or felt frustrated about my sleep while in bed or during the day.
    ```
    ``` ```

Frequency & Duration Pattern

  • 8. These sleep problems happened on three or more nights each week.
  • 9. These sleep problems have lasted for three months or longer.

Adequate Opportunity

  • 10. I usually allow myself at least seven hours in bed and a regular bedtime.

Other Causes (not scored)

  • 11. My sleep problems mainly started after drinking alcohol, caffeine, or using medicines/drugs.
  • 12. A medical or mental health condition completely explains my sleep problems.
```
Educational only: This checklist cannot diagnose or treat sleep disorders.
Privacy: Your answers stay in your browser.
Crisis: If you feel unsafe, call 988 (U.S.) or local emergency services.