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Insomnia Severity Index Score 15 to 21 - Moderate Severity Clinical Insomnia (Stage 3)


A score of 15 to 21 reflects moderate severity clinical insomnia (Stage 3).

It is important to differentiate between chronic insomnia exacerbated by pain and poorly-controlled arthritis pain.

If you are able to sleep comfortably with analgesia, this suggests the latter is the case.

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Follow the Basic Sleep Routine (button at bottom left) as well as the additional considerations for Stage 2 insomnia.


For Stage 3 moderate severity insomnia exacerbated by pain, also consider:

  • Focus on heartburn that has been exacerbated by pain relief. Taking adequate amounts of stomach protection is one strategy. Ensure that general food intake is not worsening the reflux with excess spice or large amounts of caffeine.

  • Deep breathing with meditation. These produce a remarkable physiological response which reduces pain and relaxes the body. Four breaths in followed by four breaths out just before bed will help the brain to fall asleep.