Worry about sleep is part of the disorder
Item 7 is not filler. Sleep-effort and sleep-anxiety are the mechanisms that convert a few bad nights into chronic insomnia: the harder you try to sleep, the more arousal you generate. That loop is precisely what CBT-I targets with stimulus control and sleep restriction.
- • Trying harder to sleep reliably makes it worse
- • Sleep restriction consolidates fragmented sleep within weeks
- • A 6-point drop is the standard definition of response
Chronic vs acute
Acute insomnia after a stressor is normal and usually self-limiting. Chronic insomnia disorder requires difficulty at least three nights a week for three months with daytime consequences — that duration criterion is what separates a rough patch from a condition.
FAQ
What ISI score means insomnia?
15 and above indicates clinical insomnia of at least moderate severity. 8–14 is subthreshold.
What is the first-line treatment?
Cognitive behavioral therapy for insomnia (CBT-I), which outperforms sleep medication at follow-up and is recommended first-line by major sleep societies.
Do sleep trackers help?
For some people they help; for others they fuel exactly the sleep-anxiety the index measures in item 7. If your tracker makes you dread bedtime, that is a signal.
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