![]() ![]() DSM-5 and ICSD-3 insomnia diagnostic criteria are similar because of collaborative efforts between the American Psychiatric Association and the American Association of Sleep Medicine classification task forces. The diagnostic criteria have been made more specific by putting in frequency criteria in addition, the duration has been changed to 3 months. Insomnia is a disorder in itself that needs independent clinical attention. Insomnia is insomnia is insomnia, according to Michael Sateia, 4 editor of ICSD-3. This change in insomnia diagnostic criteria in ICSD-3 and DSM-5 implies a paradigm shift. This stresses the comorbid nature of insomnia and calls for treatment of both insomnia and the medical disorder. The DSM-IV distinction into primary and secondary insomnia is removed in DSM-5. The most significant change in sleep-wake diagnostic criteria is in the insomnia classification ( Table). Two previous diagnoses have been eliminated: sleep disorder related to another mental disorder and sleep disorder related to another medical condition. DSM-5 also recognizes that coexisting medical conditions, mental disorders, and sleep disorders are interactive and bidirectional. DSM-5 underscores the need for independent clinical attention of a sleep disorder regardless of mental or other medical problems that may be present. Growing evidence has shown that sleep disorders coexist with other medical and psychiatric disorders and may not be mutually exacerbating. Restless legs syndrome and substance-/medication-induced sleep disorder.Rapid eye movement (REM) sleep behavior disorder.Non–rapid eye movement (NREM) sleep arousal disorders.Sleep-wake disorders comprise 11 diagnostic groups: ![]() The aim is to increase uniformity and consistency among health care professionals when they are assessing and treating patients with various sleep disorders. In DSM-5, the pathological and etiological factors associated with sleep-wake disorders are taken into consideration, as is the increase in awareness and knowledge gained from sleep studies. DSM-5 sleep-wake disorders are now more in sync with other medical disorders and sleep disorders classificatory systems. The DSM-5 Sleep-Wake Disorders Work Group worked closely with other nosology systems (eg, International Classification of Sleep Disorders, third edition ) to incorporate changes in diagnoses. Untreated sleep disorders can increase the risk of heart disease, motor vehicle accidents, memory problems, depression, and impaired functioning. Insomnia affects about 10% to 15% of the population, sleep apnea affects about 10%, followed by other sleep disorders, such as restless legs syndrome and circadian rhythm disorders. There are about 60 million Americans who have problems with sleep, with associated costs of about $16 billion each year in medical care. However, many individuals are affected with sleep disorders. Healthy sleep is required for restoring functioning and vitality, promoting memory consolidation, and maintaining immune function. ![]()
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