Sleep Condition Indicator

Eight questions about the past month, published by sleep researchers at the University of Oxford and offered here in full and unchanged.

Sleep Condition Indicator © Sleepio Limited. Reproduced unchanged under its free non-commercial license (Creative Commons Attribution-NonCommercial 4.0). Espie CA et al., BMJ Open 2014;4:e004183.

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Answer all 8 questions (8 left).

What This Tool Does

The Sleep Condition Indicator (SCI) asks how long it takes you to fall asleep, how long you are awake in the night, how many nights a week sleep is a problem, how you rate your sleep, how poor sleep affects your days, and how long the problem has lasted. It turns those answers into a total from 0 to 32, where higher means better sleep, and shows which answers reached the level the authors linked to insomnia disorder.

Who Made It and How It Was Tested

Colin Espie and colleagues published the SCI in BMJ Open in 2014. They tested it on 30,941 people across five samples who completed it online, and found its eight questions hang together well (internal consistency of 0.86 or higher). Its totals tracked the Pittsburgh Sleep Quality Index and the Insomnia Severity Index closely. The questions were written to match the DSM-5 description of insomnia disorder, including how often and for how long the problem happens.

The authors were careful about what it can claim. They tested the cutoff of 16 against another questionnaire, not against a clinician's diagnosis, and said studies of that kind are essential before firm conclusions. Treat it as a well-built screener, not a verdict.

Reading Your Total

A total of 16 or less is the range the authors suggested may help detect probable insomnia disorder.
A total of 17 to 32 is above that cutoff. Higher means better sleep.
On each question, answers scoring 2 or less fall in the range the authors marked as meeting the insomnia threshold for that question. The answer profile under your result shades that range.

When the authors compared it with the Insomnia Severity Index, a total of 16 or less picked out 89% of the 27 people scoring 15 or more on the ISI.

Insomnia and CPAP

Insomnia and sleep apnea often occur together. A 2019 meta-analysis of 37 studies (Zhang and colleagues, Sleep Medicine Reviews) found that 38% of people with obstructive sleep apnea met criteria for insomnia, and a 2019 review (Sweetman, Lack and Bastien, Brain Sciences) noted that insomnia symptoms tend to lower CPAP use. If your total is low, it is worth discussing with your doctor. The American College of Physicians recommends cognitive behavioral therapy for insomnia (CBT-I) as the first treatment for chronic insomnia in adults (Qaseem and colleagues, 2016). If you already use CPAP, your machine's data can show whether short or broken nights line up with how you feel, which is a useful thing to bring to that conversation.

Frequently Asked Questions

What is a good Sleep Condition Indicator score?

The SCI runs from 0 to 32, and a higher total means better sleep. Its authors suggested that a total of 16 or less may help pick out probable insomnia disorder. A total above 16 sits outside that range. They also said the cutoff still needs testing against a clinician's own assessment.

How is the Sleep Condition Indicator scored?

Each of the eight questions scores 0 to 4, with 4 the best answer. The eight scores are added for a total from 0 to 32. The authors also give a 0 to 10 version, which is the total divided by 3.2.

How is the SCI different from the Insomnia Severity Index?

Both are short insomnia questionnaires, and in the SCI's development paper the two scores moved closely together (a correlation of minus 0.79, minus because a high SCI means good sleep and a high ISI means bad sleep). The SCI was written around the newer DSM-5 insomnia criteria and includes how long the problem has lasted. The SCI is free to use for non-commercial purposes, which is why we can offer it in full.

Can I have insomnia and sleep apnea at the same time?

Yes. The two often occur together, and a doctor may look at both. If you use CPAP and your sleep still feels poor, insomnia is one possible reason worth raising with your doctor alongside your CPAP data.