Unifying Concepts

DSM-V Diagnostic Criteria for Insomnia

The American Academy of Sleep Medicine defines insomnia as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.

DSM-V Diagnostic Criteria for Insomnia
Dissatisfaction with sleep quantity or quality, with one or more of the following symptoms:

  • Difficulty initiating sleep
  • Difficulty maintaining sleep, characterized by frequent awakenings or trouble returning to sleep after awakenings
  • Early-morning awakening with inability to return to sleep

The sleep disturbance causes clinically significant distress or impairment in daytime functioning, as evidenced by at least one of the following:

  • Fatigue or low energy
  • Daytime sleepiness
  • Impaired attention, concentration, or memory
  • Mood disturbance
  • Behavioral difficulties
  • Impaired occupational or academic function
  • Impaired interpersonal or social function
  • Negative effect on caregiver or family functioning

The sleep difficulty occurs at least 3 nights per week, is present for at least 3 months, and occurs despite adequate opportunity for sleep.



  1. Winkelman JW. Insomnia Disorder. N Engl J Med. 2015 Oct 8;373(15):1437-44. [Medline]
  2. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Feb 15;13(2):307-349. [Medline]


Created Feb 02, 2018.

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