Sleep Disorders

F51 NONORGANIC SLEEP DISORDERS
Comments: a more comprehensive classification of sleep disorders is available (International Classification of Sleep Disorders1) but it should be noted that this is organized on a different basis than ICD-10. For some research purposes, where particularly homogenous groups of sleep disorders are required, a specification of 4 or more within a one-year period should be considered for categories F51.3, F51.4 and F51.5.

F51.0 Nonorganic insomnia
A.   A complaint of difficulty falling asleep, maintaining sleep, or non refreshing sleep.
B.   The sleep disturbance occurs at least three times per week for at least one month.
C.   The sleep disturbance results in marked personal distress or interference with personal functioning in daily living.
D.   Absence of any known causative organic factor, such as a neurological or other medical condition,  Psychoactive substance use disorder or a medication.

F51.1 Nonorganic hypersomnia
A.   A complaint of excessive daytime sleepiness or sleep attacks or prolonged transition to the fully aroused  state upon awakening (sleep drunkenness) (not accounted for by an inadequate amount of sleep).
B.   This sleep disturbance occurs nearly every day for at least one month or recurrently for shorter periods of  time and causes either marked distress or interference with personal functioning in daily living .
C.   Absence of auxiliary symptoms of narcolepsy (cataplexy, sleep paralysis, hypnagogic  hallucinations) or of clinical evidence for sleep apnoea (nocturnal breath cessation, typical intermittent snorting sounds, etc.).
D.   Absence of any known causative organic factor, such as a neurological or other medical condition, psychoactive substance use disorder or a medication.

F51.2 Nonorganic disorder of the sleep-wake schedule
A.   The individual's sleep-wake pattern is out of synchrony with the desired sleep-wake schedule, as imposed by societal demands and shared by most people in the individual's environment.
B. As a result of this disturbance the individual experiences insomnia during the major sleep period or hypersomnia during the waking period, nearly every day for at least one month or recurrently for shorter periods of time.
C.   The unsatisfactory quantity, quality and timing of sleep either causes marked personal distress or interferes with personal functioning in daily living.
D.   Absence of any known causative organic factor, such as a neurological or other medical condition, psychoactive substance use disorder or a medication.

F51.3 Sleepwalking [somnambulism]
A.   The predominant symptom is repeated (two or more) episodes of rising from bed during sleep and walking  about for several minutes to one half hour, usually occurring during the first third of nocturnal sleep.
B.   During an episode, the individual has a blank staring face, is relatively unresponsive to the efforts of others  to influence the event or to communicate with him or her and can be awakened only with considerable  difficulty.
C.   Upon awakening (either from an episode or the next morning), the individual has amnesia for the episode.
D.   Within several minutes of awakening from the episode, there is no impairment of mental activity or  behaviour, although there may initially be a short period of some confusion and disorientation.
E.   Absence of any evidence of an organic mental disorder, such as dementia, or a physical disorder, such as  epilepsy.

F51.4 Sleep terrors [night terrors]
A.   Repeated (two or more) episodes in which the individual gets up from sleep with a panicky scream and  intense anxiety, body motility and autonomic hyperactivity, (such as tachycardia, heart pounding, rapid  breathing and sweating).
B.   The episodes occur mainly during the first third of sleep.
C.   The duration of the episode is less than ten minutes.
D.   If others try to comfort the individual during the episode there is lack of response followed by disorientation and perseverative movements.
E.   Limited recall of the event.
F.   Absence of any known causative organic factor, such as a neurological or other medical condition, psychoactive substance use disorder or a medication.

F51.5 Nightmares
A.   Awakening from nocturnal sleep or naps with detailed and vivid recall of intensely frightening dreams, usually involving threats to survival, security or self-esteem. The awakening may occur during any time of  the sleep period, although they typically occur during the second half.
B.   Upon awakening from the frightening dreams, the individual rapidly becomes oriented and alert.
C.   The dream experience itself and the disturbance of sleep resulting from the awakenings associated with the  episodes cause marked distress to the individual.
D.   Absence of any known causative organic factor, such as a neurological or other medical condition,  psychoactive substance use disorder or a medication