- Requirements
- Lost Resource
- Avoiding Mental Illness - Graph
- AI Overview – Avoiding Mental Illness
- Build Healthy Daily Habits (For TAY Population)
- Prodromal Signs of Mental Illness
- Mental Illness Early Intervention Score 21 Items
- Content - Sleep
- Tangent - Commercial-of-the-shelf (COTS) V Modify V Derive V Create V Transform
- HBE-SA (Sleep Assessment) – 8 Pages
- Health Benefits Employee Services (HBE) Reference
- FYI - Sleep Assessment Tools
- HBE Tool – Content II
- History of Sleep Problems Impact Score – 6 Items
- Nature of Sleep – 9 Items
- Sleep and Health History Continued – 17 Items
- Energy and Fatigue
- Sleep Impairment Screener – 10 Items
- Staying Asleep – 10 Items
- Medication
- Medical Conditions – 9 Items
- Family Associated Condition Checklist – 13 Items
- Familial Associated Risk Factors
- Diseases That Run In Families
- Life Balance
- Sleep Hygiene
- Insomnia Severity Index - Transformation
- Insomnia Severity Index– Transformation – 8 Items
- Epworth Sleepiness Scale
- Chronic Sleep Deprivation
Lost Resource
This paper is centered on an eight (8) page document (Sleep
Assessment Tool) we have in our database.
We cannot find the reference document online anymore on the
internet. We searched Health Benefits
Employee Sleep Assessment Tool PDF.
Chrome updated the search algorithms and the format that we used to
enjoy on a hit page (the first page
that is returned) is gone.
AI Overview – Avoiding Mental Illness
While there is no guaranteed way to prevent all
mental illnesses, you can build resilience, lower your risk, and manage early
symptoms through healthy daily habits and proactive care.
Build Healthy Daily Habits
Get regular exercise:
Aim for 30
minutes of walking or other physical activity most days to boost your mood.
Prioritize sleep:
Get 7 to 9
hours of quality sleep each night and keep a consistent sleep schedule.
Eat a balanced diet:
Focus on
nutritious meals, stay hydrated, and limit caffeine and alcohol.
Spend time outdoors:
Natural light
and time in nature help reduce stress and improve well-being.
Strengthen Social Connections
Stay connected:
Reach out
regularly to supportive friends, family members, or peers.
Engage in your community: Join local clubs, take fitness classes, or volunteer to build a
strong sense of belonging.
Develop Coping and Mental
Skills
Practice mindfulness:
Use
meditation, deep breathing, or relaxation techniques to calm your mind.
Manage stress: Set clear goals and priorities to avoid feeling overwhelmed.
Challenge negative
thoughts:
Notice unhelpful thinking patterns and
try to reframe them with a
positive focus.
Seek Early Support
Watch for warning signs:
Notice changes
in your mood, sleep, or behavior early on.
Consult professionals:
Visit your
primary care provider or talk to a therapist if you feel overwhelmed or notice
persistent changes. You can explore guidance and resources through the National Institute of Mental Health.
Preventing Mental
Illness
HSF = High Scores are Favorable
Build Healthy Daily
Habits (For TAY Population)
- Get Exercise
- Prioritize Sleep
- Avoid Alcohol
- Avoid Delinquency
- Avoid Drugs
- Avoid Falling
- Avoid Gang-like Behaviors
- Avoid Head Injuries
- Challenge Negative Thoughts
- Consult Professionals
- Develop Coping Skills
- Eat Balanced Diet
- Educate on Mental Illness
- Engage in Your Community
- Few Chronic Health Problems
- Find Comfort with Driving
- Goal to Finish High School
- Practice Mindfulness
- Practice Safe Sex
- Seek Early Support
- Spend Time Outdoors
- Strengthen Social Connections
- Take Routine Assessments
- Warning Sign Minimize Hangovers
- Watch for Warning Signs
- Work When Off School
Associated with >
ADL_Prodromal_Signs_of_Mental_Illness_SPMI_23082902_Notes
V2026
Prodromal Signs of Mental Illness
Prodromal signs of mental
illness, particularly psychosis, are subtle,
early indicators that suggest a person is at risk of developing a
mental health condition. These signs can be non-specific, meaning they can be
associated with other conditions, but they can also indicate a heightened
vulnerability to psychosis. Recognizing these signs early is crucial for timely
intervention and potentially preventing or mitigating the full onset of a
mental illness.
Mental Illness Early Intervention Score 21 Items
LSF = Low Scores are Favorable
Scored by and for Keith “Buster” Torkelson, BS
Scored 20261019-M:
|
## |
Aspect |
FY 1987 Retro |
FY 1989 Retro Onset |
|
01 |
Altered EMOTIONS |
0.25 |
0.50 |
|
02 |
Decline in personal hygiene |
0.00 |
0.00 |
|
03 |
Depression |
0.25 |
0.00 |
|
04 |
Difficulty concentrating |
0.00 |
0.25 |
|
05 |
Fatigue |
0.25 |
1.00 |
|
06 |
Hallucination |
0.25 |
0.25 |
|
07 |
Inappropriate emotional responses |
0.00 |
0.25 |
|
08 |
Irritability |
0.00 |
0.50 |
|
09 |
Lack of motivation |
0.00 |
0.50 |
|
10 |
Loss of energy |
0.00 |
0.50 |
|
11 |
Loss of interest and pleasure |
0.00 |
0.25 |
|
12 |
Memory problems |
0.00 |
0.00 |
|
13 |
Mood Changes |
0.00 |
0.50 |
|
14 |
Neglecting personal hygiene |
0.00 |
0.00 |
|
15 |
New and heightened suspicion of others |
0.00 |
0.50 |
|
16 |
Peculiar behavior |
0.00 |
0.50 |
|
17 |
Sleep disturbances |
0.00 |
0.75 |
|
18 |
Social isolation |
0.00 |
0.25 |
|
19 |
Social withdrawal |
0.00 |
0.00 |
|
20 |
Suspiciousness |
0.00 |
0.75 |
|
21 |
Trouble understanding conversations or written materials |
0.00 |
0.50 |
|
|
CALC |
=1.00/21 |
=7.75/21 |
|
|
Mental Illness Early Intervention Score 21 Items (LSF) = |
4.8% |
36.9% |
Content - Sleep
Sleep is a vital, complex biological process that allows your body and brain to rest, restore, and repair themselves, cycling through stages of non-REM and REM sleep. Sufficient quality sleep supports physical health by strengthening the immune system, regulating hormones, and promoting growth, while also enhancing cognitive functions like memory, learning, mood, and concentration. Without enough sleep, you risk health problems, impaired daily functioning, and a lower quality of life.
Able to Sleep
To help you fall asleep, establish a consistent sleep schedule, create a relaxing bedtime routine, optimize your bedroom for sleep (dark, cool, quiet), and avoid caffeine and alcohol before bed. If you have consistent trouble sleeping, it's important to see a doctor to identify the cause, as insomnia can be a symptom of an underlying health or mental health condition. Treatments like Cognitive Behavioral Therapy (CBT) and, in some cases, short-term medication, can be effective.
Ability to Sleep
"Sleep ability" can
refer to a person's capacity
to achieve good quality, restorative sleep, which is crucial for physical and
mental health, and can be improved through good sleep hygiene, a consistent
routine, a relaxing environment, regular exercise, and a balanced diet.
Tangent - Commercial-of-the-shelf (COTS) V Modify V Derive V Create V
Transform
When determining how to acquire
or develop software, systems, or products, organizations typically evaluate a
spectrum of options. This spectrum starts with buying standard commercial
products and moves toward building
custom solutions from scratch. The core trade-off across this spectrum
is speed and cost vs. control and customization. Here is a
breakdown of how COTS, Modify, Derive,
Create, and Transform compare as product
development and acquisition strategies
Comparison Overview
|
Strategy |
Definition |
Control Over
Design |
Time to
Implement |
Cost Profile |
|
COTS (Commercial-off-the-shelf) |
Buying an existing, fully-built commercial product. |
None (Vendor lock-in) |
Fast |
Lower upfront, recurring licensing |
|
Modify (Configuration) |
Tweaking a COTS product using built-in settings or APIs. |
Low |
Fast to Medium |
Moderate implementation costs |
|
Derive (Forking/Extending) |
Using an existing as a baseline. |
Medium to High |
Medium |
Development costs to adapt material |
|
Create (Custom Build) |
Building a unique solution entirely from scratch. |
Total |
Slow |
High upfront development costs |
|
Transform (Legacy Migration) |
Complete overhaul of an existing, older system. |
Total |
Slow |
High cost, high risk |
Detailed Breakdown of the Spectrum
COTS (Commercial-Off-The-Shelf)
What it is:
Purchasing or borrowing a ready-made
product from a commercial vendor (e.g., Microsoft Office).
When to use:
When your business process is standard
and the product perfectly meets 80% or more of your needs without changes.
Pros:
Immediate deployment, vendor-backed
updates, lower initial cost.
Cons:
Zero competitive advantage, no control
over the roadmap, and you must adapt your business processes to the tool.
Modify (Configure / Customize)
What it is:
Taking a COTS product and changing its
behavior. This can range from simple configuration (changing fields) to customization (writing custom scripts).
When to use:
When a COTS product fits your main
architecture but requires specific workflows, branding, or integrations unique
to your business.
Pros:
Tailored functionality while still
leveraging a stable, vendor-supported core.
Cons:
Upgrades can become difficult if linkages
break during vendor updates ("upgrade trap").
Derive
What it is:
Taking an existing framework, open-source
querybase, or reference design and building on top of it to create a new
product variation.
When to use:
When you need a highly custom solution
but do not want to reinvent the wheel for basic components (e.g., building a
custom operating system derived from Android or Linux).
Pros:
Accelerates development significantly;
you own the derivative code.
Cons:
You inherit the technical debt and bugs
of the original format. You must also manage license compliance.
Create
What it is:
Custom software or hardware engineering
built entirely from scratch (Greenfield development).
When to use:
When the product is your core business value or competitive advantage, and no
commercial alternative exists on the market.
Pros:
Infinite flexibility, total control over
intellectual property (IP), and optimized performance for your specific use
case.
Cons:
Extremely expensive, high risk of
failure, and long time-to-market. You are solely responsible for maintenance
and updates forever.
Transform
What it is:
Modernizing, refactoring, or
re-architecting a legacy system into a modern better fitting version.
When to use:
When you have an existing system that
works but is paralyzed by technical debt or inability to scale.
Pros:
Preserves historical business logic and
data while enabling future innovation and reducing long-term maintenance costs.
Cons:
Extremely high operational risk
("changing the engines on the plane while flying"), expensive, and
often suffers from scope creep.
HBE-SA (Sleep
Assessment) – 8 Pages
Health Benefits Employee Services (HBE) Sleep Assessment
HBE Sleep Assessment Tool
Parts – Quick Score Method (QSM)
HBE Sleep Assessment Tool – Content I
The HBE Sleep Assessment
Tool (offered through Health Benefits Employee Services) is an
employee-focused wellness
questionnaire designed to evaluate an individual's sleep
hygiene, daytime fatigue levels, and potential risks for sleep disorders.
Purpose & Functionality
Rather than acting as a definitive medical diagnosis,
the tool serves as a confidential screening mechanism. It is
commonly used by human resource departments and employee benefits programs to
promote health equity, manage stress,
reduce workplace fatigue, and control healthcare costs associated with
untreated sleep conditions like chronic insomnia or obstructive sleep apnea
(OSA).
Core Components
While specific employee health
platforms vary, workplace sleep assessments typically incorporate or are
adapted from industry-standard clinical metrics:
The Epworth Sleepiness
Scale (ESS):
An 8-question
self-administered test measuring your likelihood of "dozing off" during routine daytime activities (e.g.,
watching TV, sitting in traffic, or reading). Scores range from 0 to 24, where
a score of 10 or higher typically indicates excessive daytime sleepiness.
The STOP-Bang Questionnaire:
An 8-item
screening tool consisting of simple Yes/No questions evaluating physical risk
factors for obstructive sleep apnea, including Snoring, Tiredness, Observed
apnea, high Blood pressure, BMI, Age, Neck circumference, and Gender.
Sleep Hygiene Indexes:
Questions
addressing behavioral or
environmental conditions impacting rest, such as daytime caffeine
intake, alcohol use near bedtime, consistency of wake schedules, and screen
time habits.
Outcomes & Next Steps
Upon completing the online
assessment, employees receive a standardized health risk profile
along with personalized feedback. If the results suggest an elevated risk for a
sleep disorder, the tool typically guides users toward:
Behavioral Interventions:
Digital apps, sleep-tracking
logs, or "rest recipes" designed to build healthier habits.
Clinical Navigation:
Information on
how to use corporate insurance benefits to schedule a formal, diagnostic home
sleep test or see a certified sleep
specialist.
FYI – AI - Are you looking to take the assessment as an employee, or are you an HR manager looking to implement this wellness tool for your organization? Let me know so I can provide the exact resources or guidelines you need.
FYI - Sleep Assessment Tools
The Pittsburgh Sleep Quality
Index (PSQI) is the gold-standard questionnaire used to evaluate overall
subjective sleep quality and patterns over a one-month period.
Other common sleep assessment
tools target specific symptoms or sleep disorders:
Common Questionnaires &
Scales
Insomnia Severity Index (ISI):
A 7-item tool
that measures the severity, impact, and distress of insomnia symptoms over the
past 2 weeks (scores range from 0 to 28).
Epworth Sleepiness Scale (ESS):
An 8-item
scale that measures average daytime sleepiness and the likelihood of dozing off
in daily situations (scores above 10 indicate potential excessive sleepiness).
A 28-item
self-report measure evaluating six distinct domains of sleep quality in adults.
STOP-Bang Questionnaire:
A brief
screening tool specifically used to assess risk for obstructive sleep apnea.
Objective Assessment Methods
Actigraphy:
A
non-intrusive wrist-worn
motion detector used to track sleep-wake cycles and fragmentation over extended periods.
Polysomnography (Sleep
Study):
The clinical gold standard for diagnosing sleep disorders (such as sleep apnea or narcolepsy) by measuring brain waves, heart rate, airflow, and muscle activity.
HBE Tool – Content II
An HBE
Sleep Assessment typically refers to a sleep
evaluation or program
offered through employee or corporate health and wellness initiatives (such as Health Benefits / Health and Benefits /
HBE programs like those at Sandia National Laboratories), which includes
pre-assessment questionnaires, consultations, and panels regarding behavioral and
physiological sleep factors.
What to Expect from an HBE
Sleep Assessment
Pre-Assessment
Questionnaires:
You complete a
background sleep form or health assessment tracking your sleep duration,
nighttime awakenings, and morning refreshment.
Consultation / Panel Discussion:
A discussion
with health educators or specialists reviewing lifestyle, stress, and physiological elements affecting your
sleep.
Action Plans:
Guidance or classes targeting
issues like insomnia, sleep hygiene, or referrals for formal home/lab sleep
apnea testing if required.
FYI - UI - If you are looking to schedule or prepare for a specific HBE sleep program (such as through an employer wellness portal) or trying to calculate your habitual sleep efficiency, let me know the context so I can provide the right details.
Search > Sleep Rest Assessment Tool PDF > In House Metadata >
Sleep Assessment (8 pages – rigorous) by Health Benefits Employee Services (Not Dated)
Sleep Assessment
Thank you for taking the time to
complete this extensive form. Sleep disturbances and/or fatigue are most
often the result of many factors. In
order to best treat your condition we need to understand your symptoms and
history. Please bring your completed assessment form to your
appointment.
Binary Scoring Method (Continuum)
History of Sleep Problems Impact Score – 6 Items
Sleep and Health History Continued
Self-scored August 25, 2026 (TU)
Intractable Sleep
Disorder
An "intractable sleep
disorder" refers to a persistent,
severe sleep problem, often treatment-resistant insomnia, that doesn't
improve with standard therapies like behavioral changes or medications,
characterized by chronic difficulty
falling/staying asleep, leading to daytime dysfunction despite adequate sleep
opportunity. It's a persistent, often complex condition involving issues like anxiety, psychological conflict, or
underlying medical factors, requiring specialized diagnosis and
multi-faceted management beyond basic sleep hygiene to address its chronic
nature and impact on daily life.
Nature of Sleep – 9 Items
For Year 2019 Self-scored 2019
Pass (1.00) SoSo (0.50) Fail (0.00)
LSF = Low Scores are Favorable | SW = Share(d) With
For 20261019-M: Self-scored
Pass (1.00) SoSo (0.50) Fail (0.00)
LSF = Low Scores are Favorable
C/C 2019 with 2026 = No Changes
For Year 2019 Self-scored 2019
Pass (1.00) SoSo (0.50) Fail (0.00)
Energy and Fatigue
Please describe how fatigue or
low energy affects your daily activities: Fatigue and low energy make routine
daily tasks, work duties, and personal care feel exhausting and difficult to complete.
Work and School
Low focus:
It is hard to
pay attention to details or finish tasks on time.
Slow pace:
Work takes
much longer because your brain and body move slower.
Low alertness:
You may feel
sleepy or struggle to stay awake during meetings.
Home and Self-Care
Hard chores:
Simple tasks
like washing dishes, cleaning, or cooking feel too heavy.
Basic care:
Even taking a
shower or getting dressed can feel like a major challenge.
Skipping extras:
You stop doing
optional errands or skip physical exercise.
Mental and Social Life
Brain fog:
This means
having trouble remembering things
or thinking clearly.
Low interest:
You lose the
drive to do hobbies you normally enjoy, which is called apathy.
Bad moods:
Constant
tiredness can make you feel easily annoyed, angry, or sad.
Aside - IPD
What Is Invasive Pneumococcal
Disease (IPD)?
Invasive pneumococcal disease
(IPD) is a severe, life-threatening bacterial infection that occurs when Streptococcus
pneumoniae (pneumococcus) bacteria enter parts of the body that are normally free of germs, such as
the blood, brain, or spinal cord.
Indicate which, if any, symptoms you've been having at least weekly during the past month:
Scored in Real Time 2019
Scored by and for Keith Torkelson, MS
Staying Asleep – 10 Items
Indicate which, if any, of the items listed below wake you up or keep you from sleeping
NSE = Not Specified Elsewhere | LSF = Low Scores are Favorable
Sleep and Health History Continued
Please list any medications, supplements or vitamins, prescribed or over the counter, you are currently using on a regular basis for any condition
Medication
Dose Taken for how long have you
been taking this medication?
New Baseline beginning 2024
Since 2024 for CloZAPine (150mg), Lorazepam (1mg) and Ambien (10mg)
Any side effects noted?
Potential interference with walking and standing. Potential medication related tremor. Discontinue Lithium helped with tremors. Seeing a Neurologist September 15, 2026 (TU)
Do you have any allergies to
medications? If yes, please list.
Haldol, Navane and Others
Please list any that you use to
improve your sleep
Buster uses only medication because
he lives in an assisted living
facility and it is hard to get approval to use OTCs and other helps
As of September 7, 2026 (M)
When was your last complete physical exam? March 23, 2026
(M)
Specialists that Buster saw in 2026
- Urologist
- Dermatologist
- Ophthalmologist
- Ear-Nose-Throat (ENT)
- Neurologist
- Dentist
Medical Conditions – 9 Items
As of September 7, 2026 (M)
Sleep and Health History Continued
Aside – Not in Scope - For women
only
Do you have any menstrual or
menopausal issues, such as irregular periods, painful menstrual cramps, heavy
bleeding, sleep disturbance associated with menstrual cycle, hot flashes or
night sweats… Please describe
Do you have any chronic
condition(s)/disease(s)?
If yes, please list
- Addiction to Tobacco/Nicotine
- Anxiety
- Obsessive-compulsive disorder – Cigarettes
- Scar tissue in lungs
- Sleep disorder
- Trouble walking
- With exertion hard to breathe
Anything else you think important to share regarding your
medical history?
Many Head Injuries (TBIs)
Family Associated Condition Checklist – 13 Items
Considers my parents, grandparents, and siblings
(*) Does not consider end-of-life conditions
Familial Associated Risk Factors
Familial associated risk factors
mean that a person has a higher chance of getting a disease because of shared
genes, family habits, or living environments with their blood relatives.
Key Signs of High Familial
Risk
Early age:
A relative
gets sick at a young age, such as heart disease or cancer before age 50.
Multiple relatives:
More than one
close family member has the same medical condition.
Rare patterns:
A disease
shows up in a family member of an unusual gender, like breast cancer in a male.
Common Conditions Linked to
Family History
Heart disease: Conditions like familial hypercholesterolemia cause
dangerously high cholesterol and early heart attacks.
Cancers: Inherited gene changes, such as in the BRCA1 gene, raise the risk
for breast, ovarian, and prostate cancers.
Diabetes and high blood
pressure:
These common
complex diseases run in families due to a mix of genetics and shared lifestyle
habits.
Steps to Manage Your Risk
Write down history:
Collect health information from
parents, siblings, and grandparents.
Talk to a doctor:
Share your
family medical tree so your doctor can plan earlier [U.S. Preventive Services
Task Force Guidelines] screenings.
Change habits:
Eat healthy,
exercise, and avoid smoking
to lower your overall chances of getting sick.
Diseases That Run In
Families
Family diseases are medical
conditions passed down through genes or shared among close relatives due to
similar environments and lifestyles.
Common Family Health
Conditions
Heart Disease:
Includes
coronary artery disease and high cholesterol that can pass through generations.
Cancer:
Certain types
like breast, ovarian, and colorectal cancer have strong hereditary links.
Diabetes:
Type 2
diabetes often runs in families, raising risk for siblings and children.
Single-Gene Disorders:
Rare
conditions like cystic fibrosis or sickle cell anemia are directly inherited
from parents.
Why Family History Matters
Risk Tracking:
Sharing a
health history helps doctors spot
patterns early.
Early Screening:
Knowing your
risks lets you start tests like mammograms or colonoscopies sooner.
Lifestyle Changes:
Diet and exercise habits can
lower your chances of getting shared multifactorial diseases.
Life Balance
What, if any, activities or techniques do you use to relax or manage your stressors?
Please list:
- Exercise
- Empowerment Rest
- Meditate/Mindfulness
- Literacy
- Singing
How much time do you spend per day/per week (Completed 20261019-M)
Sleep Hygiene - Alarm
Wake Up Including Using Alarm (Rarely)
Use alarm, If no,
I do not routinely use an alarm clock. On workdays I wake up at 8am and
I get out of bed at 8am. On weekends I
wake up at 7am and I get out of bed at 7am. I have a product idea for a
vibrating alarm worn on your wrist. This
way you do not wake up your roommate/bedmate with a noisy alarm
Sleep Hygiene - Exercise
Sleep Hygiene – Comfort and Environment
Do you have a comfortable sleep environment? This means an environment that includes:
- A comfortable bed
- Comfortable bedroom temperature
- A clean quiet and darkened bedroom
- Roommate sleeps 7-9 hours per night
- Peaceful and Harmonious
20260907-M = YES to All (Solo without roommate)
20261019-M-Still Solo without roommate
Do you have techniques or rituals to help you relax at
bedtime? Yes (ALL)
- Taking a warm bath or shower
- Listening to relaxing music
- Deep breathing
- Imagery
- Meditate & Mindfulness
- Singing
- Take my medication as prescribed
How soon after you awaken are
your eyes exposed to sunlight? IMMEDIATELY
How many hours before bed do you
finish eating? ONE
Do you use tobacco? YES
If yes, how many hours before bed
do you use tobacco? 1 hour
If you wake during the night do
you use tobacco? NO
Do you check the time if you
awaken at night? YES
If you awaken at night do you
stay in bed trying to return to sleep? YES
Do you drink coffee or other caffeine
containing beverages? NO
If yes, on average how many
beverages containing caffeine do you consume a day? NA
(Count an 8oz. serving as one
beverage. For example: a can of soda is
12oz. = 1 ½ beverages.)
How late in the day do you
usually drink a caffeinated beverage? NA
Do you drink alcohol? NO
If yes, how much alcohol do you
usually have, at what time of the day and how many days per week? NA
(Please list all that apply)
We only have one room (It is shared)
- Discussing the problems of the day
- Email/ computer work
- Exercise
- Paying bills
- Read
- Sing
- Sort paperwork
- Studying or work activities
- Use laptop
- Watching media
- Write
Please describe your bedtime routine (what do you do in the
hour before you go to bed)
- Lay in bed watching Disney Plus (Promotion) or other media on my Samsung (Promotion) Smartphone
- Eat a snack
- With all lights off I lie in bed and mindfully meditate
- Fall asleep usually in less than ½ hour
What do you believe is causing your sleep disturbance?
Not Sure
Please describe: I think that I have a problem with my sleep chemistry. Possibly I have Pineal Gland problems. In 2024 I remained up for 72 hours and still did not fall asleep without medication.
Insomnia Severity Index - Transformation
Please answer each of the questions below by indicating the
response that best describes your sleep
patterns in the past week.
Please answer all questions.
Please rate the current (past week’s)
Severe
Please rate the current (past week’s) 0
Absent
Difficulty staying asleep - Mild
Problem waking up too early - Mild
How SATISFIED/DISSATISFIED are you with your current sleep pattern?
Very | A Little | Some | Much Very | Satisfied
Note >
I take Medication to sleep nightly. Without medication I would be very
dissatisfied. Without a great matching
roommate I would be very dissatisfied.
Insomnia Severity Index – Original Form
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, etc.)?
Not at all | A Little | Some | Much | Very Much
How NOTICEABLE to others do you think your sleeping problem is in terms of impairing the quality of your life?
Not at all | A Little | Some | Much | Very Much
How WORRIED/DISTRESSED are you about your current sleep problem?
Not at all | A Little | Some | Much | Very Much
Sleep Chemistry & Physiology
Sleep chemistry and physiology
involve a complex interplay of brain
structures, neurotransmitters (like GABA, adenosine, histamine), and hormones (melatonin), regulated
by homeostatic "sleep pressure" (adenosine buildup) and the circadian
rhythm (body's internal clock), shifting between Non-REM (deep) and REM
(dreaming) stages, each characterized by distinct neural activity and chemical
signals that promote either sleep or
wakefulness.
Insomnia Severity
Index– Transformation – 8 Items
To what extent do you consider your sleep problem to
INTERFERE with your daily functioning (e.g., daytime fatigue, etc.)?
LSF = Low Scores are Favorable
Epworth Sleepiness Scale
“How likely are you to doze off or fall asleep in the
following situations, in contrast to feeling just tired? This refers to your usual way of life in
recent times. Even if you have not done
some of these things recently, try to work out how they would have affected
you. Use the following scale to circle [SCORE]
the most appropriate number for each situation.”
I do not doze off during the day
That you do not get drowsy during
the day is generally a positive sign
that you are getting sufficient, quality sleep at night. It suggests your
circadian rhythm is functioning properly, allowing you to stay awake and alert
during the day. However, in some cases, not feeling sleepy can be a sign of an
underlying issue, such as chronic
sleep deprivation.
Chronic Sleep Deprivation
Chronic sleep deprivation is a condition that occurs when
you consistently get fewer than 7 to 9 hours of sleep per night over an
extended period.
Symptoms
Waking up feeling unrested most mornings
Relying heavily on caffeine to get through the day
Struggling
to concentrate or focus on tasks
Noticeable changes in mood, such as increased irritability
Daytime
sleepiness or nodding off during the afternoon
Causes
Lifestyle habits,
including long work hours or late-night screen time
Stress and anxiety about
work, finances, or daily life
Sleep disorders, such as
insomnia or obstructive sleep
apnea
Irregular schedules,
like shift work or early school start times
Health Effects
Cardiovascular risks,
including a higher chance of high blood pressure and heart disease
Metabolic issues, such
as an increased risk of type 2 diabetes
Immune dysfunction,
making it easier to catch infections
Mental health strain,
which can trigger or worsen depression and anxiety
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