Psychophysiologic insomnia

This code represents a sleep-wake disorder characterized by difficulty initiating or maintaining sleep, or non-restorative sleep, that results in significant distress or impairment in functioning. The insomnia is primarily due to a conditioned arousal and negative associations with sleep, often stemming from previous episodes of insomnia. Patients typically experience heightened anxiety or cognitive arousal when attempting to sleep.

Use this code when documentation clearly indicates chronic insomnia where psychological factors, such as learned sleep-preventing associations or excessive worry about sleep, are the predominant cause. This diagnosis is often made after ruling out other medical, psychiatric, or substance-induced causes of insomnia. Supporting documentation should detail the patient's sleep difficulties, the psychological components contributing to the insomnia, and the impact on daily life.

• Differentiate from other insomnia types; ensure the documentation specifies a psychophysiological component.
• Do not code if the insomnia is secondary to another mental disorder (e.g., major depressive disorder) or a general medical condition.
• Consider co-occurring anxiety or mood disorders, but only code psychophysiologic insomnia if it's the primary sleep disturbance driven by conditioned arousal.