The International Classification of Sleep Disorders (ICSD) is "a primary diagnostic, epidemiological and coding resource for clinicians and researchers in the field of sleep and sleep medicine". The ICSD was produced by the American Academy of Sleep Medicine (AASM) in association with the European Sleep Research Society, the Japanese Society of Sleep Research, and the Latin American Sleep Society. The classification was developed as a revision and update of the Diagnostic Classification of Sleep and Arousal Disorders (DCSAD) that was produced by both the Association of Sleep Disorders Centers (ASDC) and the Association for the Psychophysiological Study of Sleep and was published in the journal Sleep in 1979. A second edition, called ICSD-2, was published by the AASM in 2005. The third edition, ICSD-3, was released by the AASM in 2014. A text revision of the third edition (ICSD-3-TR) was published in 2023 by the AASM.
Milestones of sleep disorder classifications
Introduction In 1979, the first Diagnostic Classification of Sleep and Arousal Disorders (DCSAD) was developed by the Association of Sleep Disorders Centers (ASDC) and the Association for the Psychophysiological Study of Sleep. Disorders were divided into four main categories.
Disorders of initiating and maintaining sleep (DIMS) – Insomnias Disorders of Excessive somnolence (DOES) – Hypersomnias Disorders of the Sleep-Wake Schedule – Circadian Disorders Dysfunctions Associated with Sleep, Sleep Stages, or Partial Arousals – Parasomnias In 1990, the first comprehensive classification of disorders of sleep and arousal, the International Classification of Sleep Disorders (ICSD-1990), was developed by the American Academy of Sleep Medicine (AASM) in association with the European Sleep Research Society, the Japanese Society of Sleep Research, and the Latin American Sleep Society. 84 sleep disorders were inventoried, based on pathophysiological characteristics. It was later revised as the ICSD-R in 1997. The International Classification of Sleep Disorders (ICSD) uses a multiaxial system for stating and coding diagnoses both in clinical reports or for database purposes. The axial system uses International Classification of Diseases (ICD-9-CM) coding wherever possible. Additional codes are included for procedures and physical signs of particular interest to sleep disorders clinicians and researchers. Diagnoses and procedures are listed and coded on three main "axes". The axial system is arranged as follows: Axis A ICSD Classification of Sleep Disorders Axis B ICD-9-CM Classification of Procedures Axis C ICD-9-CM Classification of Diseases (nonsleep diagnoses).
ICSD-I (1990) and ICSD-Revised (1997) Dyssomnias Intrinsic Sleep Disorders Extrinsic Sleep Disorders Circadian Rhythm Sleep Disorders Parasomnias Arousal Disorders Sleep-Wake Transition Disorders Parasomnias Usually Associated with REM Sleep Other Parasomnias Sleep Disorders Associated with Mental, Neurologic, or Other Medical Disorders Associated with Mental Disorders Associated with Neurologic Disorders Associated with Other Medical Disorders Proposed Sleep Disorders Shorter Sleeper Long Sleeper Menstrual-Associated Sleep Disorders
ICSD-2 In 2005, the International Classification of Sleep Disorders underwent minor updates and modifications resulting in version 2 (ICSD-2).
The ICSD-2 thus lists 81 sleep disorder diagnostic categories divided in 8 major categories. Each diagnostic is detailed in a description that presents the diagnostic criteria. The 81 diagnostics are divided into 8 main categories, namely insomnias, sleep-related breathing disorders, hypersomnias of central origin, circadian rhythm sleep disorders, parasomnias, sleep-related movement disorders, isolated symptoms apparently normal variants and unresolved issues, other sleep disorders. The two last categories (i.e. sleep disorders associated with disorders classified elsewhere and psychiatric disorders frequently encountered in the differential diagnosis of sleep disorders) are presented in the appendices and count 13 diagnostics. In 2006, a pocket version of the ICSD-2 was released. In this version, a pediatric section was added listing the following diagnostic categories:
Behavioural Insomnia in Childhood Onset Type Limit Setting Type Primary Sleep Apnea of Infancy Obstructive Sleep Apnea, Pediatric Congenital Central Alveolar Hypoventilation Syndrome Sleep Enuresis Restless Legs Syndrome Sleep-related Rhythmic Movement Disorder However, this classification brought some confusion into the field, which led to the revision of the classification in 2011. The classification was much more discussed by experts of the field and led to the third edition of the ICSD.
ICSD-3 (2014) and ICSD-3-TR (2023)
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