Behavioral insomnia of childhood, combined type

This code signifies a pediatric sleep disorder characterized by difficulties initiating or maintaining sleep, often due to learned associations or insufficient limit-setting by caregivers, combined with an inadequate sleep schedule. It reflects a behavioral component contributing to the sleep disturbance in children.

Apply this code when a child presents with chronic sleep problems stemming from both inappropriate sleep associations (e.g., needing a parent present to fall asleep) and inconsistent or insufficient sleep routines. This diagnosis is appropriate when both behavioral components are identified as significant contributors to the insomnia.

• Ensure documentation clearly distinguishes this combined type from sleep onset association type or limit-setting type behavioral insomnia.
• Look for physician notes indicating both learned sleep associations and issues with sleep schedule or parental limits.
• This code is specific to childhood insomnia; avoid using it for adult sleep disorders.