416 Sleep-Wake Disorders
during discontinuation/withdrawal), followed by the subtype designation (i.e., insomnia
type, daytime sleepiness type, parasomnia type , mixed type). For example, in the case of
insomnia occurring during withdrawal in a ma n with a severe lorazepam use disorder, the
diagnosis is F13.282 severe lorazepam use disorder with lorazepam-induced sleep disor-
der, with onset during withdrawal, insomnia  type. A separate diagnosis of the comorbid
severe lorazepam use disorder is not given. If  the substance-induced sleep disorder occurs
without a comorbid substance use disorder (e.g., with medication use), no accompanying
substance use disorder is noted (e.g., F19.98 2 bupropion-induced sleep disorder, with on-
set during medication use, insomnia type). When more than one substance is judged to
play a significant role in the development of the sleep disturbance, each should be listed
separately (e.g., F10.282 severe  alcohol use disorder with alcohol-induced sleep disorder,
with onset during intoxication, insomnia ty pe; F14.282 severe cocaine use disorder with
cocaine-induced sleep disord er, with onset during into xication, insomnia type).
Diagnostic Features
The essential feature of substance/medication -induced sleep disorder is a prominent sleep
disturbance that is suffi ciently severe to warrant independen t clinical attent ion (Criterion A)
and that is judged to be primarily associated with the pharmacological effects of a substance
(i.e., a drug of abuse, a medication, toxin ex posure) (Criterion B). Depending on the sub-
stance involved, one of four types of sleep di sturbances is reported. Insomnia type and day-