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DSM-IV: Primary Insomnia

Difficulty in initiating or maintaining sleep. A term that is employed ubiquitously to indicate any and all gradations and types of sleep loss.* Insomnia may be associated with any of a number of mental disorders.  When the problem exists in the absence of another cause, it is considered a separately diagnosed Dyssomnia.

Diagnostic criteria for 307.42 Primary Insomnia 
(cautionary statement)  

A. The predominant complaint is difficulty initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month. 

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). 

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

Also: agrypnia, aypnia, conditioned insomnia, initial insomnia, middle insomnia, Insomnia Related to Another Mental Disorder terminal insomnia

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*Reprinted with permission from: Culebras, Antonio Clinical Handbook of Sleep Disorders Hardcover © 1996 Butterworth-Heinemann


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