| A. | A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms: |
| 1. Difficulty initiating sleep (In children, this may manifest as difficulty initiating sleep without caregiver intervention). |
| 2. Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings (In children, this may manifest as difficulty returning to sleep without caregiver intervention). |
| 3. Early-morning awakening with inability to return to sleep. |
| B. | The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. |
| C. | The sleep difficulty occurs at least 3 nights per week. |
| D. | The sleep difficulty is present for at least 3 months. |
| E. | The sleep difficulty occurs despite adequate opportunity for sleep. |
| F. | The insomnia is not better explained by and doesnot occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia). |
| G. | The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). |
| H. | Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia. |
| Specify if: | With non-sleep disorder mental comorbidity, including substance use disorders |
| With other medical comorbidity |
| With other sleep disorder |
| Coding note: The code 780.52 (G47.00) applies to all three specifiers. Code also the relevant associated mental disorder, medical condition, or other sleep disorder immediately after the code for insomnia disorder in order to indicate the association. |
| Specify if: | Episodic: Symptoms last at least 1 month but less than 3 months. |
| Persistent: Symptoms last 3 months or longer. |
| Recurrent: Two (or more) episodes within the space of 1 year. |
| Note: Acute and short-term insomnia (i.e., symptoms lasting less than 3 months but otherwise meeting all criteria with regard to frequency, intensity, distress, and/or impairment) should be coded as an other specified insomnia disorder. |