The DSM-5-TR separates Sleep-Wake Disorders into the following specific disorders and groups:
-	Insomnia Disorder
-	Hypersomnolence Disorder
-	Narcolepsy
-	Breathing Related Sleep-Disorders*
-	Circadian Rhythm Sleep-Wake Disorders*
-	Parasomnias*
-	Restless Leg Syndrome
-	Substance / Medication-Induced Sleep Disorder
-	Other Specified Insomnia Disorder
-	Unspecified Insomnia Disorder
-	Other Specified Hypersomnolence Disorder
-	Unspecified Hypersomnolence Disorder
-	Other Specified Sleep-Wake Disorder
-	Unspecified Sleep-Wake Disorder

Note: * Groups that separate into further specific disorders

[DSM-5-TR] List of Sleep-Wake Disorders

The DSM-5-TR takes a section to briefly define important terminology related to sleep-wake disorders. These terms are broadly separated into two categories based on the type or stage of sleep, and the use of polysomnography and measurement of sleep. 
-	Sleep Stages Terms
-	Polysomnography and Measurement Terms


[DSM-5-TR] Key Concepts and Terms for Sleep-Wake Disorders

The DSM-5-TR makes a note to mention the common occurrence of co-occurring disorders that are diagnosed alongside a sleep-wake disorder. These co-occurring conditions frequently involve depression, anxiety, and cognitive changes. It is also recognized that sleep disturbances are recognized risk factors for developing other mental disorders (e.g., substance use disorder). Thus, when evaluating sleep disturbances as a differential diagnosis, the rule is to consider co-existence rather than differential diagnosis. Because of the importance of sleep on other mental or physical conditions, as well as the inverse effect of mental and physical conditions on sleep, it is important to plan treatment using a multidimensional approach that encompasses all the conditions of the patient. 

[DSM-5-TR] Note of Co-Occurring Disorders and Differential Diagnosis to Sleep-Wake Disorders

The DSM-5-TR makes an important note to specify the connection that sleep-wakes disorders, such as insomnia, have to suicidal thoughts, behavior, and death. Multiple studies, even when adjusting for depression, have correlated sleep-wake disorders and nightmares, increasing the risk of suicidal thoughts and behaviors. Some data collected on college students showed that 31.3% of those with sleep problems had suicidal thoughts, and inversely, 82.7% of those with suicidal thoughts, had sleep problems. Additionally, the American Academy of Sleep Medicine has also concluded that for teenagers, less than 8 hours of sleep is associated with increased risk for self-harm and suicidal thoughts and/or behaviors. 

[DSM-5-TR] Note of Sleep-Wake Disorders Association With Suicidal Thoughts or Behaviors

This list includes disorders or conditions that are related to states or features of sleeping, waking, or the processes that occur in between, but are not currently directly or officially included in the DSM. These disorders include:
-	Sleep Enuresis (Bedwetting)
-	Sleep Paralysis
-	Sleep-State Misperception
-	Sudden Infant Death Syndrome (SIDS)


List of Other Recognized Sleep-Wake Disorders

This list includes different types of methods for treating and/or managing different sleep-wake disorders. These include:
-	Narcolepsy Treatment 
-	Mindfulness and Effects on Insomnia
-	Insomnia Treatment Differences Between CBT-I & MBTI

Treatment & Management Methods for Sleep-Wake Disorders

This list includes different theories or concepts that are used to explain, define, or otherwise provide further insight into the workings of sleep-wake disorders. These include:
- Current Scales to Measure Sleep-Wake Disorder Symptoms


Theories & Concepts Relevant to Sleep-Wake Disorders

This includes the intersection of connections and/or research related to sleep-wake disorders as a general category in other fields of study and research. Such fields include:
-	TBD

Note: Add subjects as needed

Interdisciplinary Connections & Research Related to Sleep-Wake Disorders

The collection of references pertaining to sleep-wake disorders.

References for Sleep-Wake Disorders

Key learning objectives for understanding common sleep disorders include the ability to describe the symptoms and treatments for insomnia, sleep apnea, and narcolepsy. Additionally, one should be able to recognize the symptoms of various parasomnias and identify the risk factors and preventive measures associated with sudden infant death syndrome (SIDS).

Learning Objectives for Common Sleep Disorders

Studies indicate that a significant portion of the population, ranging from 30% to 50%, will experience a sleep disorder at some point during their lifetime. The exact percentage can vary depending on the specific population and disorder being examined (Bixler, Kales, Soldatos, Kaels, & Healey, 1979; Hossain & Shapiro, 2002; Ohayon, 1997, 2002; Ohayon & Roth, 2002).

Prevalence of Sleep Disorders

Sleep-Wake Disorders are defined using a multidimensional approach due to the expectations for co-existing or comorbid diagnosis in both mental and neurological health. They are largely characterized by individual’s interpretation of having dissatisfying sleep quality, timing, or amount of sleep. These complaints are often expressed alongside issues of distress or impairment during expected daytime activities. 

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- Sleep stages
- Sleep patterns over a lifetime
- Sleep onset
- Sleep regularity
- Biological functions of sleep
- Neural systems underlying sleep
- Sleep deprivation
- General anesthetics
- Sleep disorders
- Tracking Information During Sleep
- Sleep-wake cycle

Sleeping and waking

- Anxiety disorders
- Mood disorders 
- Psychotic disorders
- Personality disorders
- Eating disorders
- Sleep disorders
- Addiction
- Adjustment disorders

Categories of mental disorders/mental illnesses

Section II of the DSM-5-TR covers the bulk of the manual by including the descriptive text and criteria for each diagnosis. This section also references relevant context and research for the diagnoses and other conditions, medication-related adverse effects and -induced disorders, and corresponding ICD-10 codes. This section is broken down into the following chapters: 

-	Neurodevelopmental Disorders
-	Schizophrenia Spectrum and Other Psychotic Disorders
-	Bipolar and Related Disorders
-	Depressive Disorders
-	Anxiety Disorders
-	Obsessive-Compulsive and Related Disorders
-	Trauma- and Stressor-Related Disorders
-	Dissociative Disorders
-	Somatic Symptom and Related Disorders
-	Feeding and Eating Disorders
-	Elimination Disorders
-	Sleep-Wake Disorders
-	Sexual Dysfunctions
-	Gender Dysphoria 
-	Disruptive, Impulse-Control, and Conduct Disorders
-	Substance-Related and Addictive Disorders
-	Neurocognitive Disorders
-	Personality Disorders
-	Paraphilic Disorder
-	Other Mental Disorders and Additional Codes
-	Medication-Induced Movement Disorders and Other Adverse Effects of Medication
-	Other Conditions that May Be a Focus of Clinical Attention


[DSM-5-TR] Section II: Diagnostic Criteria and Codes

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

Wikipedia

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

Throughout sleep, there are different stages characterized by the presence or absence of types of brain waves. Typically, we cycle through these stages 4-5 times a night, sleeping on average 7-8 hours. These stages are broken down into two categories:

- Non-REM
- REM

Sleep Stages

The partial or total prevention of sleep. Side effects could include hallucinations, but most commonly witnessed effects are increases irritability, decreased ability to concentrate, and episodes of disorientation. Cognitive deficits are noticeable. Prolonged sleep deprivation compromises the immune system in mammals and can lead to death.

Sleep deprivation

The exact reasons we sleep are unclear and hotly debated, but there are four main explanations:

- Energy conservation
- Niche adaptation
- Body restoration
- Memory consolidation

Biological functions of sleep

Sleep library

Sleep regularity refers to whether a person sleeps and wakes at a consistent time. 

Sleep Regularity

Sleep onset is when a person transitions from a state of wakefulness and falls asleep.

Sleep Onset

A drug that renders an individual unconscious. Examples include barbiturates and anesthetic gases. They produce slow waves in the EEG that resemble the ones seen in slow wave sleep, suggesting that they tap into existing brain networks that promote sleep. Almost all are non-competitive agonists at GABA(A) receptors, boosting GABA’s inhibitory effect on neurons.

General Anesthetics

This study investigated sleepers' abilities to filter and allocate their attention towards the most relevant source of information when presented with two streams of dialogue. As of the study, there had been no evidence that the sleeping brain could covertly select which piece(s) of information to prioritize when exposed to multiple pieces of information. This study aims to see if the sleeping brain will amplify meaningful speech compared to irregular signals.

"Sleepers Track Informative Speech in a Multi-talker Environment" Legendre et al. (2019)

Sleep Library

Sleep-Wake Disorders

The sleep-wake cycle is a fundamental circadian rhythm that is internally regulated by the body's biological clock. This process governs the daily pattern of sleeping and waking, ensuring it is synchronized with the 24-hour light-dark cycle of the environment.

Sleep-Wake Cycle

Sleep-wake cycles are regulated by several brain areas working together. The thalamus, hypothalamus, and pons are key regions in this coordination: the hypothalamus includes the SCN, described as the body's biological clock, other hypothalamic nuclei work with the thalamus to regulate slow-wave sleep, and the pons helps regulate rapid eye movement (REM) sleep.

Brain Areas Regulating Sleep

Disorder Class: Disruptive, Impulse-Control, and Conduct Disorders

A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
1. Aggression to people and  animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violations of rules
 
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
 
If the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder
 
Specify age onset:  Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years

[DSM-5] Conduct Disorder Criteria

Borderline Personality Disorder (BPD) is primarily defined by a pervasive pattern of instability across interpersonal relationships, self-image, and mood, combined with significant impulsivity. Individuals with this disorder often experience intense emotions and may engage in frantic behaviors to manage their profound fear of abandonment.

Borderline Personality Disorder

A personality disorder is defined by a pervasive and inflexible personality style that significantly deviates from cultural norms, causing problems for the individual and for others. This pattern typically emerges during adolescence or early adulthood and leads to significant distress or functional impairment.

Personality Disorders

Feeding and Eating Disorders are characterized by persistent changes to eating or eating-related behaviors that result in altered consumption or absorption of food, significantly impairing an individual’s physical health and/or psychosocial functioning. 

Feeding and Eating Disorders

Mood disorders are defined as severe disturbances in mood and emotions, which can include depression, mania, and elation. Unlike typical emotional fluctuations, the mood shifts experienced in these disorders are extreme, distort an individual's perspective on life, and significantly impair their ability to function in daily activities.

Mood Disorders

Psychotic disorders are severe mental illnesses characterized by thoughts, perceptions, and behaviors that are so impaired the individual cannot function normally and becomes disconnected from reality. This state of being disconnected from the world is known as psychosis. People with these disorders often lose contact with reality and may experience extreme symptoms like hallucinations and delusions. Schizophrenia is a primary example of a psychotic disorder.

Psychotic Disorders

An adjustment disorder (AD) is a reaction to a stressful/significant life change. This reaction is marked by preoccupation with the responsible stressor shown by severe distress (more than what is typically expected) or constant thinking about the consequences of said stressor. This may alter one's mental health as a result. 

Adjustment Disorder

Anxiety disorders are characterized by features of excessive fear and anxiety, as well as related behavioral disturbances. These symptoms are often not temporary and linger beyond typical expectations. Excessiveness of these symptoms is clinician diagnosed with cultural contexts taken into consideration.

Anxiety Disorders

- Falls under the umbrella of substance use disorder. The word "addiction" is not formally recognized in the DSM-5.
- Strong, uncontrollable compulsion to administer a drug of abuse to yourself due to dependence.
- Acts on reward circuitry in the brain (dopamine) and changes the chemical composition of your brain over time.
- According to the DSM 5, only gambling addiction has been listed as a diagnosable disorder, the rest of the behavioral addictions are yet to find themselves a place on the DSM manual.

Addiction

Neurodevelopmental disorders (NDDs) are a grouping of disorders that are characterized by onset during the developmental period and present as deficits in functioning. NDDs were first introduced as a category in the DSM-5 in 2013 

NDDs include 
-Intellectual disability (ID) 
-Communication disorders
-Autism Spectrum Disorder (ASD) 
-Attention-Deficit/Hyperactivity Disorder (ADHD)
-Neurodevelopmental Motor Disorders (including tic disorders) 
-Specific Learning Disorders

Neurodevelopmental Disorders (NDDs)

Neurodevelopmental disorders are a class of conditions typically identified in childhood, characterized by developmental impairments across personal, social, academic, and intellectual domains. Key examples within this category include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder.

Neurodevelopmental Disorders

Neurocognitive Disorders are a group of disorders characterized by the primary clinical deficit of the individual being in cognitive functioning that is acquired, not developmental. These disorders have a strongly recognized and researched disease etiology to them making them a unique intersection between psychiatry and pathology. 

Neurocognitive Disorders

Substance-Related and Addictive Disorders are characterized by abusing the activation of the brain reward system through certain behaviors or the use of pharmacological substances. This often results in a sense of increased pleasure, or a “high”, encouraging reinforcement of behaviors and actions that are detrimental to or neglectful of daily activities. Due to insufficient research, repetitive behaviors that have been coined as behavioral addictions (e.g., sex addiction, exercise addiction, or shopping addiction) are excluded from this chapter.

Substance-Related and Addictive Disorders

According to the DSM-5, Depressive Disorders constitute a primary category of mood disorders characterized by depression as their central feature. This group of disorders is recognized by the presence of sad, empty, or irritable moods, along with associated somatic and cognitive changes that significantly impair an individual's ability to function. The specific disorders within this category can vary in their duration, timing, and presumed causes.

Depressive Disorders

Sexual Dysfunctions are characterized by clinically significant disturbances related to an individual’s ability to respond sexually or experience sexual pleasure. This requires a multidimensional approach to diagnoses by considering the biological, sociological, and psychological factors that influence the ways in which individuals experience sex. However, these disorders, do not include sexual dysfunctions that are a result of inadequate or a lack of stimulation or knowledge which may still be treated, but are not diagnosed.

Sexual Dysfunctions

Gender Dysphoria is characterized by the subjectively experienced distress that arises from the mismatch between gender identity, or internally felt sense of gender, and assigned sex at birth.

Gender Dysphoria

Obsessive-compulsive and related disorders are a group of conditions listed in the DSM-5 that are characterized by overlapping features, specifically the presence of intrusive thoughts and/or repetitive behaviors. This diagnostic category encompasses several distinct but related conditions, including obsessive-compulsive disorder, body dysmorphic disorder, and hoarding disorder.

Obsessive-Compulsive and Related Disorders

Bipolar and Related Disorders are recognized by unusual shifts in mood, energy, activity levels, and concentration, affecting the ability to carry out day-to-day tasks. The presence of mania is a defining trait of bipolar disorder. These shifts range from periods of manic episodes (being extremely “up”, elated, irritable, or energized) and depressive episodes (being very “down”, indifferent, or hopeless).

Bipolar and Related Disorders

Elimination Disorders are characterized by inappropriate elimination of either urine or feces. These disorders are typically diagnosed in childhood or adolescence but are based on developmental age rather than chronological age.

Elimination Disorders

A node to help create and move other nodes around

TEMP Node for DSM 

Dissociative Disorders are characterized by the disruption and/or discontinuity in the integration of consciousness, memory, motor control, perception, body representation, emotion, identity, and behavior. These symptoms can be applicable to all areas of psychological functioning and are typically experienced as unbidden intrusions into one’s awareness and behavior. This coincides with a loss of continuity in the subjective experience of the individual and/or the inability to access information or to control mental functions. 

Dissociative Disorders

Paraphilic Disorders are characterized by those paraphilias that result in distress or impairment to the individual, or, for the satisfaction of the individual, entail harm, or risk of harm, themselves or to others. Simply having a paraphilia does not meet the requirements for a diagnosis of a paraphilic disorder. 

Paraphilic Disorders

Trauma- and Stressor-Related Disorders are characterized by exposure to a traumatic or stressful event. Symptoms and reactions vary for each case and while they may be understood in an anxiety- or fear-based context, individuals often instead prominently display anhedonic, dysphoric, dissociative, and/or aggressive symptoms. This variability in the display of symptoms imposes a distinction from other similar disorders, which then also requires that for one to be diagnosed with a trauma- and stressor-disorder, they specifically must have had explicit exposure to a traumatic or stressful event.

Trauma- and Stressor-Related Disorders

Disruptive, Impulse-Control, and Conduct Disorders are a group of conditions characterized by problems related to the self-control of emotions and behaviors. These disorders are distinct from other disorders with emotional or behavioral regulation due to the nature that these problems result in violations of the rights of others and/or significant conflict with societal norms or authority figures. These disorders and their presentation can greatly vary within the category, as well as between individuals. 


Disruptive, Impulse-Control, and Conduct Disorders

Schizophrenia Spectrum and Other Psychotic Disorders are recognized through abnormalities occurring within at least one of five domains. These domains include delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms.

Schizophrenia Spectrum and Other Psychotic Disorders

Somatic Symptom and Related Disorders are characterized by the presence of prominent somatic symptoms as well as the abnormal thoughts, feelings, and/or behaviors in response to the somatic symptoms. These symptoms and the response to them result in significant distress and impairment to the individual. The symptoms themselves may sometimes be less important than the way individuals will present and interpret them.

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