Current RMA Instruments
| Reasonable Hypothesis SOP | 37 of 2019 |
| Balance of Probabilities SOP | 38 of 2019 |
SOP bulletin information for new Instruments
ICD-10-AM Coding
G47.0
Brief description
This SOP covers a disorder in which there is a persisting inability to initiate or maintain sleep, despite having adequate opportunity for sleep and suitable circumstances for sleep, and which results in clinically significant distress or impairment in functioning.
Confirming the diagnosis
The SOP definition has DSM-5 based criteria, including sleep difficulty at least three nights per week and for at least 3 months, which should be met before the SOP is applied. Note also that the SOP covers more than the disorder as described in DSM-5, by including medication-related insomnia.
The relevant medical specialist is a sleep physician or a psychiatrist.
Additional diagnoses covered by SOP
chronic insomnia disorder attributable to the effects of a substance - includes where insomnia is related to alcohol use disorder or substance use disorder, but does not include the temporary stimulating effects of e.g. caffeine consumption.
Conditions not covered by SOP
- Sleep deprivation due to*:
- a sleep environment that is not quiet, dark, comfortable and safe;
- insufficient or irregular hours available for sleep;
- overstimulation in the period prior to sleep (e.g. due to exercise/physical activity, discretionary stimulating mental activity;
- caffeine consumption or other temporary stimulating or sleep disrupting effects of drug or substance use.
- Insomnia due to sleep apnoea or another sleep-wake disorder
* not a disease or injury
Clinical onset
Clinical onset will be based on when relevant symptoms first became persistent.
Clinical worsening
The condition can have a variable course and be responsive to treatment, particulalry of an underlying cause. An assessment of worsening would be based on the level of symptoms or degree of distress or functional impairment.