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January 2011



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By John M Grohol PsyD

The DSM-5 Sleep Disorders workgroup has been especially busy. They are calling for a nearly complete overhaul of the sleep disorders category in the Diagnostic and Statistical Manual of Mental Disorders (“DSM”).

According to a presentation at the annual meeting of the American Psychiatric Association in May, Charles Reynolds, MD, suggested that the reworking of this category will make sleep problems easier for professionals to diagnose and discriminate between different sleep disorders.

He stated that the current DSM-IV puts too much emphasis on presumed causes of symptoms, something that the rest of the DSM-IV does not do. Bringing the sleep disorder section more in line with the other sections in the DSM should make it less confusing.

Primary and commonly diagnosed sleep disorders are being organized in the DSM-5 into three major categories: insomnia, hypersomnia and arousal disorder. The new DSM will allow professionals to choose amongst sub-types in each category, as can be done with many other major disorders in the manual.

Here’s a summary of some of the proposed additions and changes in the sleep disorders category for the DSM-5, slated for publication in May 2013.

These sleep disorders criteria are summarized from the proposed changes found on the DSM 5 website.

Kleine Levin Syndrome

This syndrome is characterized by a person who experiences recurrent episodes of excessive sleep (more than 11 hours/day). These episodes occur at least once a year, and are between 2 days and 4 weeks in duration.

During one of these episodes, when awake, cognition is abnormal with feeling of unreality or confusion. Behavioral abnormalities such as megaphagia or hypersexuality may occur in some episodes.

The patient has normal alertness, cognitive functioning, and behavior between the episodes.

Read in Full:  http://psychcentral.com/blog/archives/2010/06/07/dsm-5-sleep-disorders-overhaul/

Sleep-Disordered Breathing Is Common but Hard to Detect in Pediatric Patients

ScienceDaily (June 5, 2010) — According to new research presented on June 5, at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine, an estimated 18 percent of pediatric patients in a University of North Carolina-based study were at risk for sleep-related breathing disorders (SRBD). Importantly, pediatric risk was not associated with any demographic or craniofacial characteristics, as it is in adults, making it difficult to detect.

Read in Full:  http://www.sciencedaily.com/releases/2010/06/100605112533.htm

Sleep Apnea in Children and Teens Linked to Lower Academic Grades

ScienceDaily (June 8, 2010) — The average academic grades of children and teens with moderate to severe obstructive sleep apnea are worse than the grades of students who have no sleep-disordered breathing, according to a research abstract presented June 8, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC.

Results indicate that moderate to severe obstructive sleep apnea was linked to both lower academic grades and behavioral concerns expressed by parents and teachers. The results remained significant after adjustment for sex, race, socioeconomic status and sleep duration on school nights. Students with moderate to severe sleep apnea averaged a half-letter grade lower than those without any evidence of sleep-disordered breathing. None of the students with moderate to severe OSA had an “A” average, and 30 percent of them had a “C” average or lower. In contrast, roughly 15 percent of participants without sleep-disordered breathing had an “A” average, and only about 15 percent had a “C” average or lower.

Read in Full:  http://www.sciencedaily.com/releases/2010/06/100608091854.htm

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