Sleep disorder due to another medical condition. Substance/medication-induced sleep disorder and sleep disorder associated with another medical condition may produce sim- ilar symptoms of insomnia, daytime sleepiness, or a parasomnia. Many individuals with other medical conditions that cause sleep disturbance are treated with medications that may also cause sleep disturbances. The chronology of symptoms is the most important fac- tor in distinguishing between these two sources of sleep symptoms. Difficulties with sleep that clearly preceded the use of any medication for treatment of a medical condition would suggest a diagnosis of sleep disorder associated with another medical condition. Con— versely, sleep symptoms that appear only after the initiation of a particular medication/ substance suggest a substance/medication-induced sleep disorder. If the disturbance is comorbid with another medical condition and is also exacerbated by substance use, both diagnoses (i.e., sleep disorder associated with another medical condition and substance/ medication-induced sleep disorder) are given. When there is insufficient evidence to de- termine whether the sleep disturbance is attributable to a substance/ medication or to an— other medical condition or is primary (i.e., not due to either a substance/medication or another medical condition), a diagnosis of other specified sleep-wake disorder or unspec- ified sleep—wake disorder is indicated.
See the ”Comorbidity" sections for other sleep disorders in this chapter, including insom- nia, hypersomnolence, central sleep apnea, sleep-related hypoventilation, and circadian rhythm sleep-wake disorders, shift work type.
Relationship to Internationai Ciassification of
The International Classification of Sleep Disorders, 2nd Edition (ICSD-2), lists sleep disorders “due to drug or substance” under their respective phenotypes (e.g., insomnia, hypersomnia).
780.52 (647.09)
This category applies to presentations in which symptoms characteristic of insomnia disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for insomnia disorder or any of the disorders in the sleep-wake disorders diagnostic class. The other specified insomnia dis- order category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for insomnia disorder or any specific sleep—wake disorder. This is done by recording ”other specified insomnia disorder” followed by the specific reason (e.g., “brief insomnia disorder).
Examples of presentations that can be specified using the “other specified" designation include the following: 1. Brief insomnia disorder: Duration is less than 3 months.
2. Restricted to nonrestorative sleep: Predominant complaint is nonrestorative sleep unaccompanied by other sleep symptoms such as difficulty falling asleep or remaining asleep.
780.52 (647.00)
This category applies to presentations in which symptoms characteristic of insomnia disor- der that cause clinically significant distress or impairment in social, occupational. or other important areas of functioning predominate but do not meet the full criteria for insomnia dis- order or any of the disorders in the sleep-wake disorders diagnostic class. The unspecified insomnia disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for insomnia disorder or a specific sleep-wake dis- order, and includes presentations in which there is insufficient information to make a more specific diagnosis.
780.54 (647.19)