diff --git a/src/components/insights/derived/vitals-dashboard.tsx b/src/components/insights/derived/vitals-dashboard.tsx
index 76f0c1394..ce6169597 100644
--- a/src/components/insights/derived/vitals-dashboard.tsx
+++ b/src/components/insights/derived/vitals-dashboard.tsx
@@ -784,7 +784,14 @@ export function VitalsDashboard({ batch, layout, className }: DashboardProps) {
             aria-label={
               isLoading ? t("insights.derived.vitals.loadingLabel") : undefined
             }
-            className="grid grid-cols-1 gap-3 sm:grid-cols-2 lg:grid-cols-3"
+            className={cn(
+              "grid grid-cols-1 gap-3",
+              // Multi-column only when the skeleton row or more than one tile
+              // fills it; a lone tile spans the full width rather than sitting
+              // in a one-third column with dead space beside it.
+              (isLoading || vitalTiles.length > 1) &&
+                "sm:grid-cols-2 lg:grid-cols-3",
+            )}
           >
             {isLoading
               ? Array.from({ length: 6 }).map((_, i) => (
@@ -806,7 +813,12 @@ export function VitalsDashboard({ batch, layout, className }: DashboardProps) {
           />
           <div
             data-slot="vitals-mobility-grid"
-            className="grid grid-cols-1 gap-3 sm:grid-cols-2 lg:grid-cols-3"
+            className={cn(
+              "grid grid-cols-1 gap-3",
+              // A lone mobility tile spans the full width rather than
+              // orphaning a one-third column.
+              mobilityTiles.length > 1 && "sm:grid-cols-2 lg:grid-cols-3",
+            )}
           >
             {mobilityTiles.map((tile) => tile.node)}
           </div>
diff --git a/src/components/insights/device-score-tile.tsx b/src/components/insights/device-score-tile.tsx
index 178617bb1..40a10fd9c 100644
--- a/src/components/insights/device-score-tile.tsx
+++ b/src/components/insights/device-score-tile.tsx
@@ -121,7 +121,7 @@ export function DeviceScoreTile({
           </CardAction>
         ) : null}
       </CardHeader>
-      <CardContent className="space-y-3">
+      <CardContent className="space-y-3 pb-1">
         {isLearning ? (
           <LearningGate
             compact
diff --git a/src/components/insights/mood/mood-correlation-cards.tsx b/src/components/insights/mood/mood-correlation-cards.tsx
index a9b931336..e64fe1a2b 100644
--- a/src/components/insights/mood/mood-correlation-cards.tsx
+++ b/src/components/insights/mood/mood-correlation-cards.tsx
@@ -83,15 +83,21 @@ const STRENGTH_KEY: Record<CorrelationResult["strength"], string> = {
 function MoodCorrelationCard({
   kind,
   data,
+  className,
 }: {
   kind: MetricKind;
   data: MoodMetricCorrelationData;
+  className?: string;
 }) {
   const { t } = useTranslations();
   const hasResult = data.result != null && data.n >= 5;
 
   return (
-    <Card data-slot="mood-correlation-card" data-kind={kind}>
+    <Card
+      data-slot="mood-correlation-card"
+      data-kind={kind}
+      className={className}
+    >
       <CardHeader className="pb-2">
         <div className="flex items-start justify-between gap-2">
           <CardTitle className="text-sm font-semibold">
@@ -165,7 +171,15 @@ export function MoodCorrelationCards({
       <MoodCorrelationCard kind="steps" data={steps} />
       <MoodCorrelationCard kind="pulse" data={pulse} />
       <MoodCorrelationCard kind="weight" data={weight} />
-      <MoodCorrelationCard kind="bloodPressure" data={bloodPressureSystolic} />
+      {/* Five fixed cards: on the two-up sm grid the trailing card lands
+          alone in its row, so it spans full width there; the three-up lg
+          grid leaves it paired (row of 3 + row of 2) and it stays one
+          column. */}
+      <MoodCorrelationCard
+        kind="bloodPressure"
+        data={bloodPressureSystolic}
+        className="sm:col-span-2 lg:col-span-1"
+      />
     </div>
   );
 }
diff --git a/src/components/insights/mood/mood-narrative-feed.tsx b/src/components/insights/mood/mood-narrative-feed.tsx
index 2e53c899d..6560ce81d 100644
--- a/src/components/insights/mood/mood-narrative-feed.tsx
+++ b/src/components/insights/mood/mood-narrative-feed.tsx
@@ -14,6 +14,7 @@ import {
 import type { ComponentType } from "react";
 
 import { useTranslations } from "@/lib/i18n/context";
+import { cn } from "@/lib/utils";
 
 /**
  * v1.8.6 — narrative takeaway feed.
@@ -69,7 +70,12 @@ export function MoodNarrativeFeed({ items }: { items: MoodNarrativeItem[] }) {
     // ladder. Lay them two-up on anything wider than a phone; a lone
     // takeaway still spans the row rather than orphaning half of it.
     <ul
-      className="grid gap-2 sm:grid-cols-2"
+      className={cn(
+        "grid gap-2",
+        // A lone takeaway spans the row rather than orphaning half of it;
+        // two or more lay out two-up on anything wider than a phone.
+        items.length > 1 && "sm:grid-cols-2",
+      )}
       data-slot="mood-narrative-feed"
       aria-label={t("insights.mood.narrative.title")}
     >
diff --git a/src/components/insights/sleep/sleep-quality-section.tsx b/src/components/insights/sleep/sleep-quality-section.tsx
index 7813c07d2..b471c092f 100644
--- a/src/components/insights/sleep/sleep-quality-section.tsx
+++ b/src/components/insights/sleep/sleep-quality-section.tsx
@@ -4,6 +4,7 @@ import { Activity, Gauge, Moon, Repeat, Target, Waves } from "lucide-react";
 
 import { useInsightsAnalytics } from "@/hooks/use-insights-analytics";
 import { useTranslations } from "@/lib/i18n/context";
+import { cn } from "@/lib/utils";
 import { SectionHeading } from "@/components/insights/section-heading";
 import { DeviceScoreTile } from "@/components/insights/device-score-tile";
 import { DeviceScoreGridSkeleton } from "@/components/insights/device-score-tile-skeleton";
@@ -111,7 +112,14 @@ export function SleepQualitySection({ enabled }: { enabled: boolean }) {
           </p>
         }
       />
-      <div className="grid gap-4 sm:grid-cols-2">
+      <div
+        className={cn(
+          "grid gap-4",
+          // Two-up only when more than one metric has data; a lone tile spans
+          // the full row rather than leaving a half-width orphan.
+          present.length > 1 && "sm:grid-cols-2",
+        )}
+      >
         {present.map((tile) => (
           <DeviceScoreTile
             key={tile.type}
diff --git a/src/components/labs/lab-list.tsx b/src/components/labs/lab-list.tsx
index 5a832d6fd..a1e38d77e 100644
--- a/src/components/labs/lab-list.tsx
+++ b/src/components/labs/lab-list.tsx
@@ -15,6 +15,7 @@ import { formatDate } from "@/lib/format";
 import { formatReferenceRange } from "@/lib/labs/reference-range";
 import { formatLabReading, formatLabValue } from "@/lib/labs/format-value";
 import { useTranslations } from "@/lib/i18n/context";
+import { cn } from "@/lib/utils";
 import { queryKeys } from "@/lib/query-keys";
 import { applyOrder, useModuleListPrefs } from "@/lib/module-list-prefs";
 
@@ -247,7 +248,14 @@ export function LabList({ onAddFirst }: { onAddFirst?: () => void } = {}) {
   // the line-1 chip, the panel as the category badge. v1.18.10 (#3) — no delete
   // control on the tile; the trash icon lives only on the value detail view.
   return (
-    <ul className="grid list-none gap-4 p-0 sm:grid-cols-2">
+    <ul
+      className={cn(
+        "grid list-none gap-4 p-0",
+        // A lone lab spans the full row rather than orphaning half of it;
+        // two or more fall into the two-up grid.
+        groups.length > 1 && "sm:grid-cols-2",
+      )}
+    >
       {truncated ? (
         <li className="sm:col-span-2">
           <p className="text-muted-foreground text-xs">
diff --git a/src/components/mental-health/instrument-card.tsx b/src/components/mental-health/instrument-card.tsx
index be9204a70..2b24cf69b 100644
--- a/src/components/mental-health/instrument-card.tsx
+++ b/src/components/mental-health/instrument-card.tsx
@@ -36,9 +36,9 @@ export function InstrumentCard({
 
   return (
     <Card className="h-full gap-3" data-slot="instrument-card">
-      <CardContent className="flex h-full flex-col gap-4 p-4">
+      <CardContent className="flex h-full flex-col space-y-3.5 p-4">
         <div className="flex flex-col gap-0.5">
-          <span className="font-medium">
+          <span className="text-lg leading-none font-semibold">
             {t(`mentalHealth.instrument.${key}`)}
           </span>
           <span className="text-muted-foreground text-xs">