10/17/22, 11:04 PM Table 3.

Table 3.36, DSM-IV to DSM-5 Insomnia Disorder Comparison - Impact of the DSM-IV to DSM-5 Changes on the National Surve…

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on
the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental
Health Services Administration (US); 2016 Jun.

Table 3.36 DSM-IV to DSM-5 Insomnia Disorder Comparison

DSM-IV
Name: Primary Insomnia
Disorder Class: Sleep Disorders
A. The predominant complaint is
difficulty initiating or maintaining
sleep, or nonrestorative sleep, for at
least 1 month.
DSM-5
Name: Insomnia Disorder
Disorder Class: Sleep-Wake Disorders
A. A predominant complaint of dissatisfaction with
sleep quantity or quality, associated with one (or more)
of the following symptoms:
1. Difficulty initiating sleep. (In children, this may
manifest as difficulty initiating sleep without
caregiver intervention.)

2. 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.)

3. Early-morning awakening with inability to return

to sleep.

D. The sleep difficulty is present for at least 3 months.

B. The sleep disturbance (or
associated daytime fatigue) causes
clinically significant distress or
impairment in social, occupational, or
other important areas of functioning.
C. The sleep disturbance does not
occur exclusively during the course
of narcolepsy, breathing-related sleep
disorder, circadian rhythm sleep
disorder, or a parasomnia.
D. The disturbance does not occur
exclusively during the course of
another mental disorder (e.g., major
depressive disorder, generalized
anxiety disorder, a delirium).
B. The sleep disturbance causes clinically significant
distress or impairment in social, occupational,
educational, academic, behavioral, or other important
areas of functioning.
C. The sleep difficulty occurs at least 3 nights per week.
E. The sleep difficulty occurs despite adequate
opportunity for sleep.
F. The insomnia is not better explained by and does not
occur exclusively during the course of another sleep-
wake disorder (e.g., narcolepsy, a breathing-related sleep
disorder, a circadian rhythm sleep-wake disorder, a
parasomnia).
H. Coexisting mental disorders and medical conditions
do not adequately explain the predominant complaint of
insomnia.

https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t36/ 1/2
10/17/22, 11:04 PM Table 3.36, DSM-IV to DSM-5 Insomnia Disorder Comparison - Impact of the DSM-IV to DSM-5 Changes on the National Surve…

DSM-IV DSM-5
E. The disturbance is not due to the G. The insomnia is not attributable to the physiological
direct physiological effects of a effects of a substance (e.g., a drug of abuse, a
substance (e.g., a drug of abuse, a medication).
medication) or a general medical
condition.
Specify if:

With nonsleep disorder mental comorbidity,

including substance use disorders

With other medical comorbidity

With other sleep disorder

Coding note: The code 780.52 (G47.00) applies to

all three specifiers. Code also the relevant
associated mental disorder, medical condition, or
other sleep disorder immediately after the code for
insomnia disorder in order to indicate the
association.

Specify if:

Episodic: Symptoms last at least 1 month but less

than 3 months.

Persistent: Symptoms last 3 months or longer.

Recurrent: Two (or more) episodes within the

space of 1 year.

Note: Acute and short-term insomnia (i.e., symptoms

lasting less than 3 months but otherwise meeting all
criteria with regard to frequency, intensity, distress,
and/or impairment) should be coded as another specified
insomnia disorder

From: 3, Mental Illness

Copyright Notice
All material appearing in this report is in the public domain and may be reproduced or copied without permission from
SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without
the specific, written authorization of the Office of Communications, SAMHSA, HHS.

https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t36/ 2/2