814 Highlights of Changes From DSM-IV to DSM-5
Sleep-Wake Disorders
In DSM-5, the DSM-IV diagnose s named sleep disorder related to another mental disorder
and sleep disorder related to another medica l condition have been removed, and instead
greater specification of coexisting conditions is provided for each sleep-wake disorder. The
diagnosis of primary insomnia has been renamed insomnia disorder  to avoid the differen-
tiation between primary and secondary insomnia. DSM-5 also distinguishes narcolepsy —
now known to be associated with hypocretin deficiency—from other forms of hypersomno-
lence (hypersomnolence disorder ). Finally, throughout the DSM-5 classification of sleep-
wake disorders, pediatric and developmental cr iteria and text are integrated where existing
science and considerations of clinical utility support such integration. Breathing-related
sleep disorders are divided into three relatively distinct disorders: obstructive sleep apnea
hypopnea, central sleep apnea, and sleep-related hypoventilation. The subtypes of circadian
rhythm sleep disorders  are expanded to include advanced  sleep phase type and irregular
sleep-wake type, whereas the jet lag type has b een removed. The use of the former “not oth-
erwise specified” diagnoses in DSM- IV have been reduced by elevating rapid eye move-
ment sleep behavior disorder  and restless legs syndrome  to independent disorders.
Sexual Dysfunctions
In DSM-5, some gender-specifi c sexual dysfunctions have been added, and, for females,
sexual desire and arousal disorders have  been combined into one disorder: female sexual
interest/arousal disorder.  All of the sexual dysfunctions (except substance/medication-in-
duced sexual dysfunction ) now require a minimum duration of approximately 6 months and
more precise severity criteria. Genito-pelvic pain/p enetration disorder  has been added to