THE INTERNATIONAL CLASSIFICATION OF SLEEP …

1 THE. INTERNATIONAL CLASSIFICATION . OF. SLEEP DISORDERS, REVISED. Diagnostic and Coding Manual Produced by the American Academy of SLEEP Medicine in association with the EUROPEAN SLEEP RESEARCH SOCIETY. JAPANESE SOCIETY OF SLEEP RESEARCH. LATIN AMERICAN SLEEP SOCIETY. CONTENTS. Foreword .. v Preface .. vii Diagnostic CLASSIFICATION Steering Committee .. ix Alphabetical Listing of Participants .. xiv Introduction .. 1. Copyright 1990, 1997, 2001 American Academy of SLEEP Medicine, One Westbrook The Axial System .. 13. Corporate center , Suite 920, westchester , IL 60154-5767, INTERNATIONAL CLASSIFICATION of SLEEP Disorders.

2 15. Copies of the manual are available from the American Academy of SLEEP Medicine in CLASSIFICATION Outline .. 15. the Criteria .. 21. Diagnostic Criteria .. 21. All rights reserved. Unless authorized in writing by the AASM, no portion of this book Minimal Criteria.. 22. may be reproduced or used in a manner inconsistent with the copyright. This applies to Severity Criteria .. 22. unauthorized reproductions in any form, including computer programs. Sleepiness .. 23. Correspondence regarding copyright permissions should be directed to the Executive Insomnia .. 23. Director, American Academy of SLEEP Medicine, One Westbrook Corporate center , Duration Criteria.

3 24. Suite 920, westchester , IL 60154-5767, Translations to other languages must be Dyssomnias .. 25. authorized by the American Academy of SLEEP Medicine, Intrinsic SLEEP Disorders.. 27. Extrinsic SLEEP Disorders .. 72. Recommended Citations Circadian-Rhythm SLEEP Disorders .. 117. (Numerical) Parasomnias.. 141. American Academy of SLEEP Medicine. INTERNATIONAL CLASSIFICATION of Arousal Disorders.. 142. SLEEP disorders, revised: Diagnostic and coding manual. Chicago, Illinois: American SLEEP -Wake Transition Disorders .. 151. Academy of SLEEP Medicine, 2001. Parasomnias Usually Associated with REM SLEEP .

4 162. Other Parasomnias .. 181. (Alphabetical). American Academy of SLEEP Medicine. SLEEP Disorders Associated with Other Disorders .. 215. ICSD - INTERNATIONAL CLASSIFICATION of SLEEP disorders, revised: Associated with Mental Disorders .. 216. Diagnostic and coding manual. American Academy of SLEEP Medicine, 2001. Associated with Neurologic Disorders .. 234. Associated with Other medical Disorders .. 259. Library of Congress Catalog No. 97-71405 Proposed SLEEP Disorders .. 281. INTERNATIONAL CLASSIFICATION of SLEEP disorders, revised: Diagnostic and coding manual. CLASSIFICATION of Procedures.

5 311. American Academy of SLEEP Medicine. Includes bibliographies and index. ICSD Coding System .. 314. 1. SLEEP Disorders CLASSIFICATION . 2. SLEEP Disorders Diagnosis Axis A Modifiers .. 316. Diagnostic Criteria .. 316. ISBN: 0-9657220-1-5 Remission.. 316. Acute Onset .. 316. Severity .. 317. Duration .. 317. Symptom .. 317. iii Axis B .. 320 FOREWORD TO THE REVISED EDITION. Procedures .. 320. Procedure Features .. 320. Axis C .. 322 Since its introduction in 1990, the INTERNATIONAL CLASSIFICATION of SLEEP Summary .. 323 Disorders (ICSD) has gained wide acceptance as a tool for clinical practice and Procedure Feature Codes.

6 325 research in SLEEP disorders medicine. The years between 1990 and 1997 have wit- nessed wide-ranging changes in SLEEP disorders medicine from many perspec- Data Base .. 329 tives: the growth of managed health care; public health care reform; efforts to bet- Differential Diagnosis .. 331 ter integrate SLEEP disorders medicine into the community of medical specialties;. major efforts at improving public awareness of the serious toll of SLEEP disorders;. Glossary .. 337 and perhaps most importantly a rapid growth in our understanding of the patho- List of Abbreviations physiology and effective treatment of SLEEP disorders.

7 Such changes present a fundamental challenge for any CLASSIFICATION of dis- General Bibliography .. 352 eases and disorders, including the ICSD: How often and how extensively should Appendix A .. 355 the CLASSIFICATION be updated to reflect developments in the field? On the one hand, ICSD Listing by medical System.. 355 research and clinical developments have clearly changed the way we view many ICD-9-CM Listings .. 358 SLEEP disorders, most notably SLEEP -related breathing disorders. Some disorders in ICSD Alphabetical Listing .. 358 the ICSD may not be the distinct conditions conceptualized earlier ( , noctur- ICSD Numerical Listing.)

8 360 nal paroxysmal dystonia), and other conditions not recognized in the ICSD ( , ICD-9-CM SLEEP Listings upper airway resistance syndrome, SLEEP -related eating disorders) may deserve Current Procedural Terminology (CPT) Codes.. 365 their own listings. Such developments call for an in-depth revision of the classifi- Clinical Field Trials .. 366 cation system. On the other hand, frequent, major changes in a CLASSIFICATION of disorders can be disruptive for both clinical and research practice. Maintaining a Appendix B .. 367 stable definition of a syndrome over a period of time is necessary to further define Introduction to the DCSAD First Edition.

9 367 the reliability and validity of that disorder. Moreover, clinical and research DCSAD CLASSIFICATION Outline .. 378 progress has varied widely across disorders in the ICSD. Although we have great- Alphabetical Listing of DCSAD and Comparison with ICSD.. 381 ly improved our knowledge about some SLEEP disorders, the essential features of Comparative Listing of DCSAD and ICSD .. 384 other disorders (not to mention their epidemiology, pathophysiology, and treat- Index .. 389 ment) remain in the realm of expert opinion. Ideally, substantive revisions are guided by a comprehensive analysis of applied, clinical, and basic research on the disorders themselves, as well as a clear understanding of which features of the CLASSIFICATION work (and which don't work) in clinical and research practice.

10 Expert opinion is always required, but should be secondary to empirical data. At this point, the SLEEP disorders field has not conducted the type of rigorous re-examination needed to support a substantive revision of its diagnostic classifi- cation. As a result, this revision to the ICSD falls on the side of minor rather than major changes. Our intent in compiling this revision was to make the ICSD easi- er to use and more accurate, without altering the basic structure (or indeed, the vast majority of the text) of the CLASSIFICATION . The revisions are summarized as follows: 1. The listing of disorders has been made accessible by printing it on the inside cover of the book.