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Epidemiological and clinical relevance of insomnia diagnosis algorithms according to the DSM-IV and the International Classification of Sleep Disorders (ICSD)
Open accessAbstract
Background Although the epidemiology of insomnia in the general population has received considerable attention in the past 20 years, few studies have investigated the prevalence of insomnia using operational definitions such as those set forth in the ICSD and DSM-IV, specifying what proportion of respondents satisfied the criteria to reach a diagnosis of insomnia disorder.Methods This is a cross-sectional study involving 25,579 individuals aged 15 years and over representative of the general population of France, the United Kingdom, Germany, Italy, Portugal, Spain and Finland. The participants were interviewed on sleep habits and disorders managed by the Sleep-EVAL expert system using DSM-IV and ICSD classifications.Results At the complaint level, too short sleep (20.2%), light sleep (16.6%), and global sleep dissatisfaction (8.2%) were reported by 37% of the subjects. At the symptom level (difficulty initiating or maintaining sleep and non-restorative sleep at least 3 nights per week), 34.5% of the sample reported at least one of them. At the criterion level, (symptoms+daytime consequences), 9.8% of the total sample reported having them. At the diagnostic level, 6.6% satisfied the DSM-IV requirement for positive and differential diagnosis. However, many respondents failed to meet diagnostic criteria for duration, frequency and severity in the two classifications, suggesting that multidimensional measures are needed.Conclusions A significant proportion of the population with sleep complaints do not fit into DSM-IV and ICSD classifications. Further efforts are needed to identify diagnostic criteria and dimensional measures that will lead to insomnia diagnoses and thus provide a more reliable, valid and clinically relevant classification.
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“it is thought that 6%–10% of the general population suffer from chronic insomnia disorder”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [7]
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“when more rigorous insomnia criteria are used to determine insomnia rates (i.e., diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders IV; DSM IV), the prevalence in adults decreases to 6–10% [38,39].”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [38]
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Metadata
- Authors
- Ohayon, M. M., & Reynolds, C. F.
- Affiliations
- Stanford Medicine (US)
- University of Pittsburgh (US)
- Corresponding author
- Ohayon, Maurice M.
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 10
- Issue
- 9
- Pages
- 952-960
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC3715324
- OpenAlex
- W1965622047
- Cited by
- 432
- References
- 27
- Citations by year
- 2026: 15 · 2025: 38 · 2024: 43 · 2023: 29 · 2022: 31 · 2021: 36 · 2020: 31 · 2019: 23 · 2018: 23 · 2017: 25 · 2016: 24 · 2015: 25 · 2014: 25 · 2013: 27 · 2012: 12
- FWCI
- 15.21
- Type
- journal article
- Language
- en
- Update notices
- erratum (2010-02-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01NS044199)
- Medical Center, University of Pittsburgh (P30 MH71977)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- insomnia, insomnia prevalence, diagnostic criteria, DSM-IV, International Classification of Sleep Disorders, sleep complaints, non-restorative sleep, sleep dissatisfaction, general population
- MeSH terms
- Adult, Aged, Algorithms, Cross-Sectional Studies, Decision Trees, Diagnosis, Differential, Europe, Female, Health Surveys, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Prevalence, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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