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Chapter V

Nonorganic sleep disorders - F51


In many cases, a disturbance of sleep is one of the symptoms of another disorder, either mental or physical. Whether a sleep disorder in a given patient is an independent condition or simply one of the features of another disorder classified elsewhere, either in this chapter or in others, should be determined on the basis of its clinical presentation and course as well as on the therapeutic considerations and priorities at the time of the consultation. Generally, if the sleep disorder is one of the major complaints and is perceived as a condition in itself, the present code should be used along with other pertinent diagnoses describing the psychopathology and pathophysiology involved in a given case. This category includes only those sleep disorders in which emotional causes are considered to be a primary factor, and which are not due to identifiable physical disorders classified elsewhere.
    Excludes:
  • sleep disorders (organic) ( G47.- )
F51.0 Nonorganic insomnia
F51.1 Nonorganic hypersomnia
A condition of unsatisfactory quantity and/or quality of sleep, which persists for a considerable period of time, including difficulty falling asleep, difficulty staying asleep, or early final wakening. Insomnia is a common symptom of many mental and physical disorders, and should be classified here in addition to the basic disorder only if it dominates the clinical picture.
    Excludes:
  • hypersomnia (organic) ( G47.1 )
  • narcolepsy ( G47.4 )
F51.2 Nonorganic disorder of the sleep-wake schedule
A lack of synchrony between the sleep-wake schedule and the desired sleep-wake schedule for the individual's environment, resulting in a complaint of either insomnia or hypersomnia.
Psychogenic inversion of (rhythm):
  • circadian
  • nyctohemeral
  • sleep
      Excludes:
    • disorders of the sleep-wake schedule (organic) ( G47.2 )
  • F51.3 Sleepwalking [somnambulism]
    A state of altered consciousness in which phenomena of sleep and wakefulness are combined. During a sleepwalking episode the individual arises from bed, usually during the first third of nocturnal sleep, and walks about, exhibiting low levels of awareness, reactivity, and motor skill. Upon awakening, there is usually no recall of the event.
    F51.4 Sleep terrors [night terrors]
    Nocturnal episodes of extreme terror and panic associated with intense vocalization, motility, and high levels of autonomic discharge. The individual sits up or gets up, usually during the first third of nocturnal sleep, with a panicky scream. Quite often he or she rushes to the door as if trying to escape, although very seldom leaves the room. Recall of the event, if any, is very limited (usually to one or two fragmentary mental images).
    F51.5 Nightmares
    Dream experiences loaded with anxiety or fear. There is very detailed recall of the dream content. The dream experience is very vivid and usually includes themes involving threats to survival, security, or self-esteem. Quite often there is a recurrence of the same or similar frightening nightmare themes. During a typical episode there is a degree of autonomic discharge but no appreciable vocalization or body motility. Upon awakening the individual rapidly becomes alert and oriented.
    Dream anxiety disorder
    F51.8 Other nonorganic sleep disorders
    F51.9 Nonorganic sleep disorder, unspecified
    Emotional sleep disorder NOS


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