The Dyssomnia Not Otherwise Specified category is for insomnias, hypersomnias, or circadian rhythm disturbances that do not meet criteria for any specific Dyssomnia. Examples include
- Complaints of clinically significant insomnia or hypersomnia that are attributable to environmental factors (e.g., noise, light, frequent interruptions).
- Excessive sleepiness that is attributable to ongoing sleep deprivation.
- Idiopathic "Restless Legs Syndrome": uncomfortable sensations (e.g., discomfort, crawling sensations, or restlessness) that lead to an intense urge to move the legs. Typically, the sensations begin in the evening before sleep onset and are temporarily relieved by moving the legs or walking, only to begin again when the legs are immobile. The sensation can delay sleep onset or awaken the individual from sleep.
- Idiopathic periodic limb movements ("nocturnal myoclonus"): repeated low-amplitude brief limb jerks, particularly in the lower extremities. These movements begin near sleep onset and decrease during stage 3 or 4 non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. Movements usually occur rhythmically every 20-60 seconds, leading to repeated, brief arousals. Individuals are typically unaware of the actual movements, but may complain of insomnia, frequent awakenings, or daytime sleepiness if the number of movements is very large.
- Situations in which the clinician has concluded that a Dyssomnia is present but is unable to determine whether it is primary, due to a general medical condition, or substance induced.
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