Insomnia Severity Index Score 22 to 28 - Severe Clinical Insomnia (Stage 4)
A score of 22 to 28 is associated with severe clinical insomnia (Stage 4).
This is likely to be caused by severe arthritis which may be poorly controlled or reflect a lack of adequate input from your medical team.
In addition to the recommendations for Stages 1 to 3, you should consult with a healthcare professional to get the support needed.
Additional factors which may be contributing to Stage 4 insomnia:
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Elevated thyroid hormones which can exacerbate insomnia and are measured through thyroid function tests.
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Menopause in women.
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Night shift work.
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Obstructive sleep apnoea; this occurs more frequently in those who are overweight and is associated with snoring. It reduces the overall quality of sleep.