Free Screening - Assessment Insomnia

General Instruction

For each question below, please circle the number corresponding most accurately to your sleep patterns in the LAST 2 WEEKS.

1. Difficulty falling asleep None Mild Moderate Severe Very Severe

2. Difficulty staying asleep None Mild Moderate Severe Very Severe

3. Problem waking up too early in the morning None Mild Moderate Severe Very Severe

4. How SATISFIED/dissatisfied are you with your current sleep pattern? Very Dissatisfied Dissatisfied Neutral Satisfied Very Satisfied

5. To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, ability to function at work/daily chores, concentration, memory, mood)? Not at all Interfering A little Interfering Somewhat Interfering Very Interfering Extremely Interfering

6. How NOTICEABLE to others do you think your sleeping problem is in terms of impairing the quality of your life? Not at all Noticeable A little Noticeable Somewhat Noticeable Very Noticeable Extremely Noticeable

7. How WORRIED/distressed are you about your current sleep problem? Not at all A little Somewhat Very Extremely

Name (Optional)

Email (Optional)

Your Screening Result

Score:

Scores Interpetation:

Thank you for taking the time to complete our insomnia screening test. We appreciate your initiative to take care of your mental health and commend you for your willingness to seek help.

Please keep in mind that the results of this screening test are for informational purposes only and should not be used as a substitute for professional medical advice or treatment. Having high scores in this questionnaire does not necessarily mean that you are having sleep disorder. We encourage you to seek professional help if you have any concerns about your mental health.

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If you are in a life-threatening situation or in danger, please call the free 24-hour hotlines: Talian Kasih at 15999 or Befrienders at 03-79568145 for immediate help. In case of an emergency, dial 999 or go to your nearest hospital. Please note that we are not a 24-hour mental health clinic.

Home / Assessment / Insomnia Screening

Insomnia Screening

General Instruction

Your Screening Result

Score:

Scores Interpetation:

Get Your First Consultation