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DSM-IV: Substance-Induced Sleep Disorder

When there is evidence that prominent sleep disturbance is directly due to exposure to medications, toxins, alcohol or other drugs, diagnosis of this Substance Related Disorder may be appropriate.

Diagnostic criteria for Substance-Induced Sleep Disorder

A. A prominent disturbance in sleep that is sufficiently severe to warrant independent clinical attention.

B. There is evidence from the history, physical examination, or laboratory findings of either (1) or (2):

(1) the symptoms in Criterion A developed during, or within a month of, Substance Intoxication or Withdrawal
(2) medication use is etiologically related to the sleep disturbance

C. The disturbance is not better accounted for by a Sleep Disorder that is not substance induced. Evidence that the symptoms are better accounted for by a Sleep Disorder that is not substance induced might include the following: the symptoms precede the onset of the substance use (or medication use); the symptoms persist for a substantial period of time (e.g. about a month) after the cessation of acute withdrawal or severe intoxication, or are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use; or there is other evidence that suggests the existence of an independent non-substance-induced Sleep Disorder (e.g. a history of recurrent non-substance-related episodes).

D. The disturbance does not occur exclusively during the course of a delirium.

E. The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Note: This diagnosis should be made instead of a diagnosis of Substance Intoxication or Substance Withdrawal only when the sleep symptoms are in excess of those usually associated with the intoxication or withdrawal syndrome and when the symptoms are sufficiently severe to warrant independent clinical attention.

Code [Specific Substance]-Induced Sleep Disorder:

291.82 Alcohol (291.89 before 10.01.2005; 291.8 before 10.01.96)
292.85 Amphetamine, Caffeine, Cocaine, Opioid, Sedative, Hypnotic, or Anxiolytic, Other [or Unknown] Substance (292.85 before 10.01.2005)

Specify type:
Insomnia Type: if the predominant sleep disturbance is Insomnia
Hypersomnia Type: if the predominant sleep disturbance is Hypersomnia
Parasomnia Type: if the predominant sleep disturbance is a Parasomnia
Mixed Type: if more than one sleep disturbance is present and none predominates

Specify if (see table on p. 177 for applicability by substance):
With Onset During Intoxication: if the criteria are met for Intoxication with the substance and the symptoms develop during the intoxication syndrome
With Onset During Withdrawal: if criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, a withdrawal syndrome

Based on the Diagnostic & Statistical Manual of Mental Disorders, 4th edition APA

Associated with these drugs: alcohol, amphetamine-like, caffeine, cocaine, opioids, sedatives, hypnotics

The online Diagnostic & Statistical Manual of Mental Disorders lists most of the major psychological disorders and illnesses and lists the criteria that must be fulfilled in order for a diagnosis to be made. This resource is not a substitute for proper professional psychiatric diagnosis.