DSM-IV diagnostic criteria for sleep disorders related to another mental disorder or a general medical condition

A. The predominant complaint is difficulty initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month that is associated with daytime fatigue or impaired daytime functioning.

B. The sleep disturbance (or daytime sequelae) causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The insomnia is judged to be related to another Axis I or Axis II disorder (e.g., major depressive disorder, generalized anxiety disorder, adjustment disorder with anxiety) but is sufficiently severe to warrant independent clinical attention.

D. The disturbance is not better accounted for by another sleep disorder (e.g., narcolepsy, breathing-related sleep disorder, a parasomnia).

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

A. The predominant complaint is excessive sleepiness for at least 1 month as evidenced by either prolonged sleep episodes or daytime sleep episodes that occur almost daily.

B. The excessive sleepiness causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The hypersomnia is judged to be related to another Axis I or Axis II disorder (e.g., major depressive disorder, dysthymic disorder) but is sufficiently severe to warrant independent clinical attention.

D. The disturbance is not better accounted for by another sleep disorder (e.g., narcolepsy, breathing-related sleep disorder, a parasomnia) or by an inadequate amount of sleep.

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

A. A prominent disturbance in sleep that is sufficiently severe to warrant independent clinical attention.

B. There is evidence from the history, physical examination, or laboratory findings that the sleep disturbance is the direct physiological consequence of a general medical condition.

C. The disturbance is not better accounted for by another mental disorder (e.g., an Adjustment Disorder in which the stressor is a serious medical illness).

D. The disturbance does not occur exclusively during the course of a delirium.

E. The disturbance does not meet the criteria for breathing-related sleep disorder or narcolepsy.

F. The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify type:

  .52 Insomnia type: if the predominant sleep disturbance is insomnia

  .54 Hypersomnia type: if the predominant sleep disturbance is hypersomnia

  .59 Parasomnia type: if the predominant sleep disturbance is a parasomnia

  .59 Mixed type: if more than one sleep disturbance is present and none predominates

Coding note: Include the name of the general medical condition on Axis I, e.g., 780.52 sleep disorder due to chronic obstructive pulmonary disease, insomnia type; also code the general medical condition on Axis III (see Appendix G for codes).