5/04/2011

ICD-10 Diagnostic Criteria for Non-Organic Insomnia

ICD-10 is the International Statistical Classification of Diseases and Related Health Problems 10th Revision. It is a coding of diseases, signs and symptoms, abnormal findings, complaints social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO).

The diagnostic criteria for Non-Organic Insomnia is as follows:

A. The complaint is either of difficulty falling asleep or maintaining sleep, or of poor
quality sleep;
Same items as in DSM-IV
B. The sleep disturbance has occurred at least three times per week for at least 1
month;
The 3 days a week part is met in the coding above for Criterion A
The 1 month part is operationalized in the same way as DSM-IV, namely:
SL21 ≥ 30 days (For how many weeks, months, or years have you had at least one of these problems?)
C. There is preoccupation with the sleeplessness and excessive concern over its
consequences at night and during the day;
SL36A = 3-4 (R has moderate or severe concerns about the sleep problems)
OR
SL36B = 4-5 (R has much or very much worries or distress about the sleep problems)
D. The unsatisfactory quantity and/or quality of sleep either causes marked distress or interferes with ordinary activities in daily living.
We created a count of responses to all the daytime impairment items to operationalize this criterion.
SUM the number of responses in the SL28-34 series that were coded 3-4 plus whether or not SL35 was coded 4 plus the sum of the SL41-44 series that were coded 7-10.
Impairment is initialized to zero.
28. reduced motivation mod/sev - If SL28=3 or 4 then impairment=impairment + 1
29. reduced performance at work, school, or social activities mod/sev - IF SL29=3 or 4 then impairment = impairment + 1
30. errors or accidents mod/sev - If SL30=3 or 4 then impairment=impairment + 1
31. irritability, nerves, mood disturbance mod/sev - If SL31=3 or 4 then impairment=impairment + 1
32. daytime attention, concentration, or memory problems mod/sev - If SL32=3 or 4 then impairment=impairment + 1
33. daytime fatigue mod/sev - If SL33=3 or 4 then impairment=impairment + 1
34. daytime sleepiness mod/sev - If SL34=3 or 4 then impairment=impairment + 1
35. tension headaches or digestive problems SEVERE (NOT MOD/SEV) - If SL35=4 then impairment=impairment + 1
41. sleep probs interfered with home management 7-10/0-10 - If SL41 ≥ 7 then impairment=impairment +1
42. sleep probs interfered with ability to work 7-10/0-10 - If SL42 ≥ 7 then impairment=impairment +1
43. sleep probs interfered with social life 7-10/0-10 - If SL43 ≥ 7 then impairment=impairment +1
44. sleep probs interfered with close relationships 7-10/0-10 - If SL44 ≥ 7 then impairment=impairment +1
We say that Criterion D is met if impairment ≥ 2

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