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How Sleep Disorders are Classified by Doctors

Think you might have a sleep disorder? When you talk to your primary care doctor or visit a sleep specialist, your healthcare provider may use information published by a professional society to help pinpoint your diagnosis.

There are several medical manuals in use today. The Diagnostic Classification of Sleep and Arousal Disorders was the first such manual, published in 1979. It organized disorders by symptom, forming the basis of the classification system in use today. The International Classification of Sleep Disorders (ICSD) is a manual written by the American Academy of Sleep Medicine (AASM), a professional society of sleep doctors. To get the “international” designation, the AASM uses input from other sleep societies, including the European Sleep Research Society, the Japanese Society of Sleep Research, and the Latin American Sleep Society.

The most recent ICSD is ICSD-3, which groups sleep disorders into six major categories:

  • Insomnia
  • Sleep Related Breathing Disorders
  • Central Disorders of Hypersomnolence
  • Circadian Rhythm Sleep-Wake Disorders
  • Parasomnias
  • Sleep Related Movement Disorders

Depending on which type of healthcare professional you visit, your provider may consult a different manual. Psychiatrists use the DSM, the Diagnostic and Statistical Manual of Mental Disorders, developed by the American Psychiatric Association.

The World Health Organization produces the widely accepted International Classification of Diseases, which covers sleep disorders as well as other somatic and psychiatric diseases.

The 11th version of the ICD is due out in 2018.

Researchers and medical experts understand that while these manuals are comprehensive and have value to doctors and their patients, they do have limitations. For example, it’s important to note that although the ICSD is considered to be a comprehensive manual of sleep disorders, it does not differentiate between pediatric and adult sleep disorders, except for pediatric OSA. So pediatricians must use care when using the ICSD to diagnose sleep disorders in children.

In the words of researcher Michael J. Sateia, “Although the criteria for each diagnosis have been reviewed and revised carefully to be as sensitive and specific to the disorder as possible, the reality is that there is much still unknown about the classification of these disorders.”

What this means for you: Your provider may consult a manual when determining whether you have a sleep disorder, but he or she will also rely on observations, medical history, and his or her own professional expertise when making a diagnosis.

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