ICSD.pdf (application/pdf Object)
THE
INTERNATIONAL CLASSIFICATION
OF
SLEEP DISORDERS, REVISED
Diagnostic and Coding Manual
Produced by the
American Academy of Sleep Medicine
in association with the
EUROPEAN SLEEP RESEARCH SOCIETY
JAPANESE SOCIETY OF SLEEP RESEARCH
Link:
http://www.esst.org/adds/ICSD.pdf
http://www.sleepcentral.org.
FOREWORD TO THE REVISED EDITION
Since its introduction in 1990, the International Classification of Sleep
Disorders (ICSD) has gained wide acceptance as a tool for clinical practice and
research in sleep disorders medicine. The years between 1990 and 1997 have witnessed wide-ranging changes in sleep disorders medicine from many perspectives:
- the growth of managed health care; public health care reform; efforts to better
integrate sleep disorders medicine into the community of medical specialties;
- major efforts at improving public awareness of the serious toll of sleep disorders;
-and–perhaps most importantly–a rapid growth in our understanding of the pathophysiology and effective treatment of sleep disorders.
Such changes present a fundamental challenge for any classification of diseases
and disorders, including the ICSD:
How often and how extensively should the classification be updated to reflect developments in the field?
On the one hand, research and clinical developments have clearly changed the way we view many sleep disorders, most notably sleep-related breathing disorders.
Some disorders in the ICSD may not be the distinct conditions conceptualized earlier (e.g., nocturnal paroxysmal dystonia), and other conditions not recognized in the ICSD (e.g.,
upper airway resistance syndrome, sleep-related eating disorders) may deserve
their own listings.
Such developments call for an in-depth revision of the classification
system.
On the other hand, frequent, major changes in a classification of
disorders can be disruptive for both clinical and research practice.
Maintaining a stable definition of a syndrome over a period of time is necessary to further define the reliability and validity of that disorder.
Moreover, clinical and research progress has varied widely across disorders in the ICSD.
Although we have greatly improved our knowledge about some sleep disorders, the essential features of other disorders (not to mention their epidemiology, pathophysiology, and treatment) remain in the realm of expert opinion.
Ideally, substantive revisions are guided by a comprehensive analysis of applied, clinical, and basic research on the disorders themselves, as well as a clear understanding of which features of the classification work (and which don’t work) in clinical and research practice.
Expert opinion is always required, but should be secondary to empirical data.
At this point, the sleep disorders field has not conducted the type of rigorous re-examination needed to support a substantive revision of its diagnostic classification.
As a result, this revision to the ICSD falls on the side of minor rather than
major changes.
Our intent in compiling this revision was to make the ICSD easier to use and more accurate, without altering the basic structure (or indeed, the vast majority of the text) of the classification.
The revisions are summarized as
follows:
1. The listing of disorders has been made accessible by printing it on the
inside cover of the book. Diagnostic codes and page numbers are also
included with this listing.
2. Text for individual disorders has been revised to clarify textual errors,
standardize format across disorders, and correct minor factual errors.
3. Minor changes have been made to the text for a few of the disorders (e.g.,
obstructive sleep apnea syndrome, apnea of infancy, narcolepsy, fibrositis syndrome) to reflect crucial developments since the first edition.
READ MORE:
http://www.esst.org/adds/ICSD.pdf
THE
INTERNATIONAL CLASSIFICATION
OF
SLEEP DISORDERS, REVISED
Diagnostic and Coding Manual
Produced by the
American Academy of Sleep Medicine
in association with the
EUROPEAN SLEEP RESEARCH SOCIETY
JAPANESE SOCIETY OF SLEEP RESEARCH
Link:
http://www.esst.org/adds/ICSD.pdf
http://www.sleepcentral.org.
FOREWORD TO THE REVISED EDITION
Since its introduction in 1990, the International Classification of Sleep
Disorders (ICSD) has gained wide acceptance as a tool for clinical practice and
research in sleep disorders medicine. The years between 1990 and 1997 have witnessed wide-ranging changes in sleep disorders medicine from many perspectives:
- the growth of managed health care; public health care reform; efforts to better
integrate sleep disorders medicine into the community of medical specialties;
- major efforts at improving public awareness of the serious toll of sleep disorders;
-and–perhaps most importantly–a rapid growth in our understanding of the pathophysiology and effective treatment of sleep disorders.
Such changes present a fundamental challenge for any classification of diseases
and disorders, including the ICSD:
How often and how extensively should the classification be updated to reflect developments in the field?
On the one hand, research and clinical developments have clearly changed the way we view many sleep disorders, most notably sleep-related breathing disorders.
Some disorders in the ICSD may not be the distinct conditions conceptualized earlier (e.g., nocturnal paroxysmal dystonia), and other conditions not recognized in the ICSD (e.g.,
upper airway resistance syndrome, sleep-related eating disorders) may deserve
their own listings.
Such developments call for an in-depth revision of the classification
system.
On the other hand, frequent, major changes in a classification of
disorders can be disruptive for both clinical and research practice.
Maintaining a stable definition of a syndrome over a period of time is necessary to further define the reliability and validity of that disorder.
Moreover, clinical and research progress has varied widely across disorders in the ICSD.
Although we have greatly improved our knowledge about some sleep disorders, the essential features of other disorders (not to mention their epidemiology, pathophysiology, and treatment) remain in the realm of expert opinion.
Ideally, substantive revisions are guided by a comprehensive analysis of applied, clinical, and basic research on the disorders themselves, as well as a clear understanding of which features of the classification work (and which don’t work) in clinical and research practice.
Expert opinion is always required, but should be secondary to empirical data.
At this point, the sleep disorders field has not conducted the type of rigorous re-examination needed to support a substantive revision of its diagnostic classification.
As a result, this revision to the ICSD falls on the side of minor rather than
major changes.
Our intent in compiling this revision was to make the ICSD easier to use and more accurate, without altering the basic structure (or indeed, the vast majority of the text) of the classification.
The revisions are summarized as
follows:
1. The listing of disorders has been made accessible by printing it on the
inside cover of the book. Diagnostic codes and page numbers are also
included with this listing.
2. Text for individual disorders has been revised to clarify textual errors,
standardize format across disorders, and correct minor factual errors.
3. Minor changes have been made to the text for a few of the disorders (e.g.,
obstructive sleep apnea syndrome, apnea of infancy, narcolepsy, fibrositis syndrome) to reflect crucial developments since the first edition.
READ MORE:
http://www.esst.org/adds/ICSD.pdf
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