2025 ICD-10-CM code F51.12
Insufficient sleep syndrome.A sleep disorder characterized by voluntary sleep deprivation due to lifestyle factors or work schedules.
Medical necessity for treating ISS is established by demonstrating the impact of insufficient sleep on the individual's physical and mental well-being. This can be supported by documenting the symptoms, impaired functioning, and negative consequences related to sleep deprivation. It's also essential to rule out other medical or psychological conditions that might be contributing to the sleep problems.
Providers diagnose ISS based on patient history, including sleep patterns, lifestyle, work schedule, and social activities. Physical examination and assessment of symptoms like lethargy, irritability, difficulty concentrating, and daytime sleepiness are essential. Additional diagnostic tools may include sleep diaries, polysomnography, and multiple sleep latency tests to rule out other sleep disorders. Treatment focuses on improving sleep hygiene and increasing sleep duration to alleviate symptoms.
- 6 (Mental, Behavioral and Neurodevelopmental disorders)
- F51 - Sleep disorders not due to a substance or known physiological conditionF51.1 - Hypersomnia not due to a substance or known physiological condition
In simple words: Insufficient sleep syndrome (ISS) is when someone doesn't get enough sleep because they choose to stay up late or wake up early, often because of work, lifestyle, or social reasons. This is different from other sleep problems where getting enough sleep is difficult.
Insufficient sleep syndrome (ISS), also known as voluntary sleep curtailment, is a sleep disorder characterized by voluntary sleep deprivation, often due to lifestyle choices, work schedules (like night shifts), or social demands. Individuals with ISS consciously choose to reduce their sleep time, leading to chronic sleep deficiency. This contrasts with other sleep disorders where sleep is disrupted involuntarily.It's important to differentiate ISS from sleep deprivation due to other medical or psychological conditions.
Example 1: A 28-year-old individual works night shifts and struggles with daytime sleepiness, difficulty concentrating, and irritability.Their sleep diary and history reveal they consistently obtain only 5-6 hours of sleep per night due to work demands and social activities., A student regularly stays up late studying and playing video games, resulting in chronic fatigue, poor academic performance, and difficulty focusing in class. Their sleep history reveals they average less than 6 hours of sleep per night despite having adequate opportunity to sleep more., A new parent experiences chronic sleep deprivation due to frequent nighttime awakenings to care for their infant. While the disrupted sleep is initially involuntary, they continue to restrict their own sleep during the day despite having opportunities for naps, leading to symptoms of ISS.
Detailed sleep history including usual sleep patterns, duration, and quality.Documentation of lifestyle factors, work schedule, and social activities influencing sleep.Symptoms such as fatigue, difficulty concentrating, irritability, and daytime sleepiness.Results of any sleep studies (e.g., polysomnography, multiple sleep latency test).Sleep diary if used.
** It's important to consider the potential impact of social determinants of health (SDOH) when evaluating insufficient sleep. Factors such as housing instability, food insecurity, or lack of transportation could indirectly affect sleep patterns. Be sure to explore these factors with the patient and document them when applicable.
- Specialties:Sleep medicine specialists, neurologists, psychiatrists, primary care physicians
- Place of Service:Office, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home