DSM 5 (Diagnostic and Statistical Manual) is an American-based classificatory system. In the DSM 5, what was initially termed “Primary insomnia” is now termed as “Insomnia disorder.” Sleep disorders are classified under “Sleep Wake disorders.” In the DSM 5, the following symptoms must be problematic for at least three days a week for at least three months. This is similar to the duration of criteria under the ICD 11. Additionally, identical to the requirements of ICD 11, there must be an opportunity to sleep well, and sleep difficulties must occur despite that opportunity.
- The main complaint must be dissatisfaction with sleep’s quantity (duration) or quality (nature) of sleep. Other symptoms must also be present as follows.
- Difficulty falling asleep. In children, this will be present as being unable to sleep without the caregiver. Difficulty maintaining sleep after getting to sleep, waking up in between, and having problems returning to sleep after waking up must also be present. Waking up earlier than usual and unable to get back to sleep.
- Sleep disturbance must cause significant distress or impairment in social, occupational, educational, academic, behavioural, or other important areas of functioning.
- Any other sleep-related or sleep-wake disorder must not explain the sleep difficulties.
- Mental disorders, which may also be present, must not adequately explain the predominant complaint of insomnia.
- The sleep disturbance must not be due to the physiological effects of a substance, such as a drug of abuse or a medication.
You can use the “Sleep Condition Indicator” questionnaire to learn more about your sleep patterns. This is not a diagnostic equivalent but a tool to understand your sleep patterns.
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How long does it take for you to fall asleep in the last month?
0 – 15 min (score 4) 16 – 30 min (score 3) 31 – 45 min (score 2) 46 – 60 min (score 1) ≥ 61 (score 0).
2. If you wake up during the night, add the total number of minutes you were awake in the last month. What is the total duration?
0 – 15 min 16 – 30 min 31 – 45 min 46 – 60 min ≥ 61
3. How many nights per week have you had a sleep problem in the last month?
0 – 1(score 4) | 2 (score 3) | 3 (score 2) | 4 (score 1) | 5 – 7 (score 0).
4. How do you rate your sleep quality?
Very good (score 4) | Good (score 3) | Average (score 2) | Poor (score 1) | Very poor (score 0)
5. How does your sleep quality affect your mood, energy and relationships?
Not at all (score 4) | A little (score 3) | Somewhat (score 2) | Much (score 1) | Very much (score 0)
6. How has your sleep quality affected your concentration, productivity and ability to stay awake?
Not at all (score 4) | A little (score 3) | Somewhat (score 2) | Much (score 1) | Very much (score 0)
7. How has your sleep pattern troubled you in general?
Not at all (score 4) | A little (score 3) | Somewhat (score 2) | Much (score 1) | Very much (score 0)
8. How long have you had problems with your sleep?
I don’t have a problem (score 4) < 1 mo (score 3) 1 – 2 mo (score 2) 3 – 6 mo (score 1)7 – 12 mo> 1 yr (score 0)
Now, add the scores. A higher score means your sleep is better. Lower scores mean you are struggling with a sleep issue.
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