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Sleep Med. 2015 Apr;16(4):477-82. doi: 10.1016/j.sleep.2014.10.018. Epub 2015 Jan 21.

Cross-cultural and comparative epidemiology of insomnia: the Diagnostic and statistical manual (DSM), International classification of diseases (ICD) and International classification of sleep disorders (ICSD).

Author information

1
Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China. Electronic address: kfchung@hkucc.hku.hk.
2
School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR, China.
3
Department of Psychology, The University of Hong Kong, Hong Kong SAR, China.
4
Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China.
5
Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China.

Abstract

OBJECTIVE:

To compare the prevalence of insomnia according to symptoms, quantitative criteria, and Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th Edition (DSM-IV and DSM-5), International Classification of Diseases, 10th Revision (ICD-10), and International Classification of Sleep Disorders, 2nd Edition (ICSD-2), and to compare the prevalence of insomnia disorder between Hong Kong and the United States by adopting a similar methodology used by the America Insomnia Survey (AIS).

METHODS:

Population-based epidemiological survey respondents (n = 2011) completed the Brief Insomnia Questionnaire (BIQ), a validated scale generating DSM-IV, DSM-5, ICD-10, and ICSD-2 insomnia disorder.

RESULTS:

The weighted prevalence of difficulty falling asleep, difficulty staying asleep, waking up too early, and non-restorative sleep that occurred ≥3 days per week was 14.0%, 28.3%, 32.1%, and 39.9%, respectively. When quantitative criteria were included, the prevalence dropped the most from 39.9% to 8.4% for non-restorative sleep, and the least from 14.0% to 12.9% for difficulty falling asleep. The weighted prevalence of DSM-IV, ICD-10, ICSD-2, and any of the three insomnia disorders was 22.1%, 4.7%, 15.1%, and 22.1%, respectively; for DSM-5 insomnia disorder, it was 10.8%.

CONCLUSION:

Compared with 22.1%, 3.9%, and 14.7% for DSM-IV, ICD-10, and ICSD-2 in the AIS, cross-cultural difference in the prevalence of insomnia disorder is less than what is expected. The prevalence is reduced by half from DSM-IV to DSM-5. ICD-10 insomnia disorder has the lowest prevalence, perhaps because excessive concern and preoccupation, one of its diagnostic criteria, is not always present in people with insomnia.

KEYWORDS:

DSM-5; DSM-IV-TR; ICD-10; ICSD-2; Insomnia; Prevalence

PMID:
25761665
DOI:
10.1016/j.sleep.2014.10.018
[Indexed for MEDLINE]

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