Insomnia severity check (ISI)

The Insomnia Severity Index is a seven-item questionnaire used in clinical practice and research to measure how severe insomnia is and whether it is improving. It scores 0 to 28, with 8 and above indicating insomnia worth addressing and 15 and above indicating moderate to severe insomnia. It is a severity measure, not a diagnosis, and it does not identify the cause — which in the menopause transition is frequently night sweats or untreated sleep apnoea.

Sleep problems affect around half of women in the menopause transition, and the first useful step is measuring how bad it actually is. Clinicians use the Insomnia Severity Index for exactly that, and the same seven questions appear below.

The score matters for a practical reason: cognitive behavioural therapy for insomnia is first-line treatment for chronic insomnia, ahead of medication, and it is far more likely to be offered to someone who arrives with a measured score than to someone who says they sleep badly.

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Sources

• Sleep Foundation — Insomnia
• NICE NG23 — Menopause: diagnosis and management
• The Menopause Society — patient education

Other self-checks