Criteria A–F must be met
The patient reports, or the patient’s parent or caregiver observes, one or more of the following:
Difficulty initiating sleep Difficulty maintaining sleep Waking up earlier than desired Resistance to going to bed on appropriate schedule Difficulty sleeping without parent or caregiver intervention
The patient reports, or the patient’s parent or caregiver observes, one or more of the following related to the nighttime sleep difficulty:
Fatigue/malaise Attention, concentration or memory impairment Impaired social, family, occupational or academic performance Mood disturbance/irritability Daytime sleepiness Behavioral problems (e.g. hyperactivity, impulsivity, aggression) Reduced motivation/energy/initiative Proneness for errors/accidents Concerns about or dissatisfaction with sleep
The reported sleep/wake complaints cannot be explained purely by inadequate opportunity (i.e. enough time is allotted for sleep) or inadequate circumstances (i.e. the environment is safe, dark, quiet and comfortable) for sleep. The sleep disturbance and associated daytime symptoms occur at least three times per week The sleep disturbance and associated daytime symptoms have been present for at least 3 months The sleep/wake diffficulty is not explained more clearly by another sleep disorder
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307.42 (F51.01)
A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:
Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.) Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.) Early-morning awakening with inability to return to sleep.
The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. The sleep difficulty occurs at least 3 nights per week. The sleep difficulty is present for at least 3 months. The sleep difficulty occurs despite adequate opportunity for sleep. The insomnia is not better explained by and does not occur exclusively during the course of another sleepwake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia). The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.
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