Vibrocise Painsomnia Insomnia Severity Index – Please answer all questions 1. Difficulty falling asleep*NoneMildModerateSevereVery severe2. Difficulty staying asleep*NoneMildModerateSevereVery severe3. Problems waking up too early*NoneMildModerateSevereVery severe4. How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?*Very SatisfiedSatisfiedModerately SatisfiedDissatisfiedVery Dissatisfied5. How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?*Not at all noticeableA littleSomewhatMuchVery much noticeable6. How WORRIED/DISTRESSED are you about your current sleep problem?*Not at all worriedA littleSomewhatMuchVery much worried7. To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY?*Not at all interferingA littleSomewhatMuchVery much interferingTotal Score*Name* First Last Email address* Enter Email Re-enter Email Confirm subscriptiom Click submit to receive your insomnia severity index (sleep score) by email. To receive information explaining your score and additional tips on improving sleep, you will need to complete the double opt-in process (check your Inbox for an email from Vibrocise Painsomnia to confirm your subscription).