Date amended:
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Statements of Principles

Depressive disorder - A sleep disorder Factor

A sleep disorder means a dyssomnia, a sleep disorder related to another mental disorder other than depressive disorder, a sleep disorder due to a general medical condition or substance-induced sleep disorder, as defined in DSM-IV-TR.

DSM-IV-TR states:

Dyssomnias are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterised by a disturbance in the amount, quality, or timing of sleep.  This section includes primary insomnia, primary hypersomnia, narcolepsy, breathing-related sleep disorder (includes sleep apnoea), circadian sleep disorder, and dyssomnia not otherwise specified (includes insomnia due to environmental factors, and restless legs syndrome).  Parasomnias, abnormal behaviours associated with sleep, are not dyssomnias.

A sleep disorder related to another mental disorder other than depressive disorder, involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder, but that is sufficiently severe to warrant independent clinical attention.

A sleep disorder due to a general medical condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system. An example of a direct physiological effect would be pain from a musculoskeletal disease.

A substance-induced sleep disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

Whilst these conditions are diagnoses under DSM-IV-TR they do not need to be confirmed by a psychiatric specialist.

Last reviewed for CCPS 16 September 2011.

Preliminary questions [37328]

37429 there is some evidence that a sleep disorder may be a factor in the development or worsening of the condition under consideration.

37430 the veteran has had a sleep disorder at some time.

37431  a sleep disorder means a dyssomnia, a sleep disorder related to another mental disorder other than depressive disorder, a sleep disorder due to a general medical condition or substance-induced sleep disorder, as defined in DSM-IV-TR.

37432  the veteran has established the causal connection between the sleep disorder and VEA service for depressive disorder.

39676   the condition under consideration is major depressive episode, recurrent major depressive disorder, dysthymic disorder or depressive disorder not otherwise specified.

37433   the veteran has established the causal connection between the sleep disorder and VEA service for the clinical onset of depressive disorder.

37436  the veteran has established the causal connection between the sleep disorder and eligible service for the clinical onset of depressive disorder.

or

37435  the veteran has established the causal connection between the sleep disorder and operational service for the clinical onset of depressive disorder.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

37434   the veteran has established the causal connection between the sleep disorder and VEA service for the clinical worsening of depressive disorder.

37438  the veteran has established the causal connection between the sleep disorder and eligible service for the clinical worsening of depressive disorder.

or

37437  the veteran has established the causal connection between the sleep disorder and operational service for the clinical worsening of depressive disorder.

Clinical onset and operational service [37435]

37439 the veteran had the identified illness or injury, a sleep disorder, for the six months before the clinical onset of depressive disorder.

37443  the identified illness or injury, a sleep disorder, is causally related to operational service.

Clinical onset and eligible service [37436]

37440 the veteran had the identified illness or injury, a sleep disorder, for the one year before the clinical onset of depressive disorder.

37444  the identified illness or injury, a sleep disorder, is causally related to eligible service.

Clinical worsening and operational service [37437]

37443  the identified illness or injury, a sleep disorder, is causally related to operational service.

37445 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a sleep disorder, is causally related.

Clinical worsening and eligible service [37438]

37442 the veteran had the identified illness or injury, a sleep disorder, for the one year before the clinical worsening of depressive disorder.

37444  the identified illness or injury, a sleep disorder, is causally related to eligible service.

37446 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a sleep disorder, is causally related.