Eating Disorders;

Sleep Disorders


Anorexia Nervosa         Bulimia Nervosa    

Primary Insomnia      Primary Hypersomnia       Narcolepsy

Breathing-Related Sleep Disorder       Circadian Rhythm Sleep Disorder

Nightmare Disorder      Sleep Terror Disorder

Sleepwalking Disorder     Insomnia Related to [Axis I or Axis II disorder]

Hypersomnia Related to [Axis I or Axis II disorder]

Sleep Disorder Due to a General Medical Condition

Substance-Induced Sleep Disorder

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Eating Disorders

Anorexia Nervosa

Specify whether:

Binge-Eating/Purging Type. During an anorectic episode, the patient often purges (vomits, uses laxatives or diuretics) or eats in binges.

Restricting Type. No bingeing or purging during an anorectic episode. This is the more usual type.


Bulimia Nervosa

Specify whether:

Purging type: The patient often induces vomiting or misuses diuretics or laxatives. This is the more common type.

Nonpurging type: The patient fasts or exercises excessively but does not often induce vomiting or misuse diuretics or laxatives.


Sleep Disorders

Primary Insomnia


Primary Hypersomnia

Specify if Recurrent: For at least 2 years, periods of hypersomnia lasting 3 days or more have occurred several times a year.




Breathing-Related Sleep Disorder

Coding Note

On Axis III, also code Sleep-Related Breathing Disorder. For example,

Axis III 780.57 Obstructive Sleep Apnea


Circadian Rhythm Sleep Disorder


Delayed Sleep Phase Type. The patient repeatedly has trouble getting to sleep and trouble awakening on time.

Jet Lag Type. Alertness and sleepiness occur at inconvenient times of day after traveling across more than one time zone.

Shift Work Type. Because of night shift work or frequently changing job shifts, the patient experiences excessive sleepiness during major periods of wakefulness or insomnia during major sleep period.

Unspecified Type.


Nightmare Disorder


Sleep Terror Disorder


Sleepwalking Disorder


Insomnia Related to [Axis I or Axis II disorder]


Hypersomnia Related to [Axis I or Axis II disorder]


Sleep Disorder Due to a General Medical Condition

Based on predominant symptoms, specify:

     780.52 Insomnia Type
     780.54 Hypersomnia Type
     780.59 Parasomnia Type
     780.59 Mixed Type (there is more than one type and none predominates)

Coding Note

Use the name of the actual general medical condition in the Axis I name.

Code the general medical condition itself on Axis III.


Substance-Induced Sleep Disorder

Codes for Substance-Induced Sleep Disorders

291.8 Alcohol

292.89 Amphetamine (or Amphetamine-Like Substance), Caffeine, Cocaine, Opioid, Sedative, Hypnotic, or Anxiolytic, Other [or Unknown] Substance

Depending on the dominant symptomatology, specify whether:

     Insomnia Type
     Hypersomnia Type
     Parasomnia Type
     Mixed Type (there is more than one type and none predominates)

If criteria are met for intoxication or withdrawal with the particular substance and symptoms develop during that phase, specify:

     With Onset During Intoxication
     With Onset During Withdrawal

Coding Notes

*No other sleep disorder must better account for the symptoms than does substance abuse. Historical information could suggest that this is the case:

a. Sleep disorder symptoms precede the onset of substance abuse.

b. There have been previous episodes of a sleep disorder not related to substance abuse.

c. The symptoms are much worse than you would expect for the amount and duration of the substance abuse.

d. Sleep disorder symptoms continue long (at least a month) after substance abuse or withdrawal stops.

The diagnosis of a Substance-Induced Sleep Disorder should be made only when the symptoms considerably exceed what you would expect from an ordinary case of Intoxication or Withdrawal from that specific substance.


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