Insomnia: Symptom or diagnosis?

  • Zwi R
  • Shawe-Taylor M
  • Murray J
 et al. 
  • 1


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.


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.

Author-supplied keywords

  • Arthralgia
  • Attention
  • Behavioral treatments
  • CBT-I
  • Chronic insomnia
  • Co-morbidity
  • Cognitive processes
  • Cognitive therapy
  • Comorbidity
  • Cross-sectional
  • DSM-5
  • DSM-IV
  • DSM-V
  • Depression
  • Diabetes
  • Epidemiology
  • HUNT 3
  • Health surveys
  • Hypnotics
  • ICD-10
  • ICSD-2
  • Insomia
  • Insomnia
  • Mental disorders
  • Misperception
  • Monitoring
  • Population surveillance
  • Prevalence
  • Preventative treatment
  • Primary
  • Safety behavior
  • Secondary
  • Self-reported health
  • Sleep
  • Sleep hygiene
  • Sleep restriction
  • Stimulus control
  • Therapeutic sleep deprivation
  • Treatment
  • Trends
  • Worry
  • anxiety
  • beliefs
  • cognitive processes
  • insomnia

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • Rachel Zwi

  • Metka Shawe-Taylor

  • James Murray

  • Benjamin Langs??ter Uhlig

  • Trond Sand

  • Siv Steinsmo ??deg??rd

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free