DSM-V SLEEP WAKE DISORDERS
INSOMNIA DISORDER
Diagnostic Criteria:
A. Dissatisfaction with sleep quantity and
quality associated with:
• Difficulty initiating sleep/maintaining
sleep characterized by frequent
awakenings or problems turning to
sleep after awakenings.
• Early-morning awakening with
inability to return to sleep.
B. Causes clinically significant distress in
areas of functioning.
C. Occurs at least 3 night per week.
D. Present at least 3 months
E. Sleep difficulty occurs despite adequate
opportunity for sleep.
F. Not better explained by and does not
occur exclusively during another sleep-
wake disorder.
G. Not attributable to physiological effects
of a substance.
H. Coexisting medical conditions do not
adequately explain the predominant
complaint.
Specify if:
With non-sleep disorder mental comorbidity
With another medical comorbidity
With other sleep disorder
Specify if:
Episodic – symptoms last for 1 month but less
than 3 months.
Persistent – last 3 months or longer.
Recurrent – two or more episodes within the
1 year.
HYPERSOMNOLENCE DISORDER
Diagnostic Criteria:
A. Self-reported excessive sleepiness
(hypersomnolence) despite a main
sleep period lasting at least 7 hours, with
one of the following:
• Recurrent periods of sleep/lapses
into sleep within the same day.
• Prolonged main sleep episode of
more than 9 hours per day that is
nonrestorative.
• Difficulty being fully awake after
abrupt awakening.
B. Occurs at least 3 times per week, for at
least 3 months.
C. Causes clinically significant distress in
areas of functioning.
D. Not better explained by and does not
occur exclusively during another sleep-
wake disorder.
E. Not attributable to physiological effects
of a substance.
F. Coexisting medical conditions do not
adequately explain the predominant
complaint.
Specify if:
With mental disorder
With medical condition
With other sleep disorder
Specify if:
Acute – duration less than 1 month
Subacute – 1-3 months
Persistent – more than 3 months.
Specify current severity:
Mild - difficulty maintaining daytime
alertness 1-2 days/week.
Moderate - difficulty maintaining daytime
alertness 3-4 days/week.
Severe - difficulty maintaining daytime
alertness 5-7 days/week.
NARCOLEPSY
Diagnostic Criteria:
A. Recurrent periods of uncontrollable
need/ lapsing into sleep within the same
day, occurring at least 3 times per week
over the past 3 months.
B. Episodes of cataplexy (muscles
weakness) that are caused by
emotional triggers (laughing, etc.).
C. Hypocretin deficiency
D. Sleep latency less than or equal to 15
minutes.
Specify whether:
Narcolepsy without cataplexy but with
hypocretin deficiency
DSM-V SLEEP WAKE DISORDERS
Narcolepsy without cataplexy but without explained by another mental SLEEP-RELATED HYPOVENTILATION
hypocretin deficiency disorder.
2. 15 or more obstructive Diagnostic Criteria:
Autosomal dominant cerebellar ataxia,
apneas/hypopneas per hour of sleep A. Episodes of decreased respiration
deafness, and narcolepsy
regardless of accompanying symptoms. associated with elevated CO2 levels,
Autosomal dominant narcolepsy, obesity, and its absence, persistent low levels of
Specify current severity:
and type 2 diabetes hemoglobin oxygen saturation
Mild – apnea hypopnea index is less than 15. unassociated with apneic/ hypopneic)
Narcolepsy secondary to another medical
B. Not better explained by another current
condition Moderate – apnea hypopnea index is 15 -
sleep disorder.
30.
Specify current severity:
Specify whether:
Severe – apnea hypopnea index is greater
Mild – infrequent cataplexy (less than than 30. Idiopathic hypoventilation
once/week), need for naps only once or
twice per day, and less disturbed nocturnal CENTRAL SLEEP APNEA Congenital central alveolar hypoventilation
sleep.
Diagnostic Criteria: Comorbid sleep-related hypoventilation
Moderate – Cataplexy (once daily/every
A. Five or more central apneas per hour of Specify current severity:
few days), disturbed nocturnal sleep, and
sleep.
need for multiple naps daily. Severity is graded according to the
B. Not better explained by another current
frequency of hypoxemia and hypercarbia
Severe – Drug-resistant cataplexy with sleep disorder.
present during sleep.
multiple attacks daily, nearly constant
Specify whether:
sleepiness, and disturbed nocturnal sleep. CIRCADIAN RHYTHM SLEEP-WAKE
Idiopathic central sleep apnea DISORDERS
BREATHING-RELATED SLEEP DISORDER
Cheyne-Stokes breathing Diagnostic Criteria:
OBSTRUCTIVE SLEEP APNEA HYPOPNEA
Central Sleep apnea comorbid with opioid A. Persistent pattern of sleep disruption due
Diagnostic Criteria: use to alteration of circadian system.
A. Either: Specify current severity: B. Sleep disruption leads to excessive
1. At least 5 obstructive sleepiness/insomnia.
apneas/hypopneas per hour of sleep Severity is graded according to the C. Causes significant distress in areas of
either: frequency of breathing disturbances, functioning.
• Nocturnal breathing disturbances/ oxygen desaturation, and sleep
daytime sleepiness, fatigue/ fragmentation that occur because of
unrefreshing sleep despite sufficient repetitive respiratory disturbances.
opportunity to sleep that is not better
DSM-V SLEEP WAKE DISORDERS
Specify whether: Specify whether: Specify if:

1. Delayed Sleep Phase Type Sleep terror type Acute – duration less than 1 month

Specify if: Sleepwalking Type Subacute – greater than 1 month but less
than 6 months.
• Familial Specify if:
• Overlapping with non-24-hour sleep- Persistent – more than 6 months.
With sleep-related eating
wake type
Specify current severity:
2. Advanced sleep phase type With sleep-related sexual behavior
(sexsomnia) Mild – less than 1 episode per week on
Specify if:
average.
• Familial NIGHTMARE DISORDER
Moderate - 1 or more episode per week but
3. Irregular sleep-wake type Diagnostic Criteria: less than nightly.
4. Non-24-hour sleep wake type
5. Shift work type A. Recurrent dysphoric and well- Severe – episodes nightly.
remembered dreams that usually
PARASOMNIAS involve efforts to avoid threats to survival, RAPID EYE MOVEMENT SLEEP BEHAVIOR
during second half of the major sleep DISORDER
NON-RAPID EYE MOVEMENT SLEEP
period.
AROUSAL DISORDERS B. On awakening from dreams, individual Diagnostic Criteria:

Diagnostic Criteria:
A. Recurrent episodes of incomplete
awakening from sleep, occurring during
first third of the major sleep disorder
episode, accompanied by:
• Sleepwalking/Sleep terrors
B. No or little dream is recalled.
C. Amnesia for the episodes is present.
D. Causes clinically significant distress in
areas of functioning.
E. Not attributable to physiological effects
of a substance.
F. Coexisting medical conditions do not
explain the episodes in Criterion A.
rapidly becomes oriented and alert. A. Repeated episodes of arousal during
C. Causes clinically significant distress in sleep associated with complex motor
areas of functioning. behaviors.
D. Nightmare symptoms are not B. Behaviors arise during REM sleep and
attributable to physiological effects of a occur for more than 90 minutes after
substance. sleep onset, more frequent during the
E. Coexisting medical conditions do not later portions of sleep.
explain the predominant complaints of C. On awakening, individual is completely
dysphoric dreams. awake and alert.
Specify if: D. Either of the:
• REM sleep without atonia
During Sleep onset E. Causes clinically significant distress in
areas of functioning.
With associated non-sleep disorder
F. Disturbance is not attributable to
With associated medical condition physiological effects of a substance.

With associated other sleep disorder

DSM-V SLEEP WAKE DISORDERS
G. Coexisting medical conditions do not
explain the episodes.

RESTLESS LEGS SYNDROME

Diagnostic Criteria:

A. Urge to move legs in response to

uncomfortable sensations in the legs:
B. Criterion A occur at least 3 times/week
and persistent for at least 3 months.
C. Criterion A is accompanied by clinically
significant distress in areas of functioning.
D. Criterion A is not attributable to
physiological effects of a substance/
another medical condition.

SUBSTANCE/MEDICATION-INDUCED
SLEEP DISORDER
Diagnostic Criteria:

A. Severe disturbance in sleep.

B. There is evidence from physical
examination:
C. Criterion A is not better explained by a
sleep disorder that is not
substance/medication induced.
D. Does not occur exclusively during the
course of a delirium.
E. Causes clinically significant distress in
areas of functioning.