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Clinical overview

• Insomnia disorder is the pattern of not being able to fall asleep, stay asleep, or get back to sleep in a way that actually affects daytime life. The diagnosis becomes more convincing when the sleep complaint is persistent, happens despite adequate opportunity to sleep, and starts showing up as fatigue, irritability, poor concentration, or reduced functioning.
• Opportunity matters: A patient can only meet criteria if there is enough time and a reasonable setting for sleep. Chronic sleep deprivation from schedule alone is not the same thing.
• Daytime impact: The complaint should not stop at the night. Daytime fatigue, mood change, cognitive problems, or functional impairment help make it a disorder rather than a preference or nuisance.
• Clinical frame: It helps to ask whether the problem is with sleep onset, sleep maintenance, early morning awakening, or a mix of all three, because that often changes management.

Related Guides

• Insomnia Disorder DSM Criteria Guide
• Insomnia Disorder Scales and Assessment Tools
• Insomnia Disorder Treatments and Medications
• When to Seek Professional Help for Insomnia Disorder