Which of the following describes the DSM criteria for insomnia disorder?

• A. A pattern of naps during day and sleepiness.
• B. Predominant dissatisfaction with sleep quantity or quality with difficulty initiating/maintaining sleep or early morning awakening, at least 3 nights per week for 3 months, distress or impairment, not due to another condition.
• C. One night of insomnia symptoms.
• D. Sleep terrors with amnesia.

Answer: (B)

The main point being tested is the specific DSM-5 criteria that define insomnia disorder. Insomnia is not just trouble sleeping; it involves a persistent pattern of dissatisfaction with sleep quantity or quality plus actual difficulty with sleep initiation, maintenance, or early morning awakening, leading to distress or impairment. Importantly, these symptoms must occur at least three nights per week and persist for at least three months, and they cannot be better explained by another condition, another sleep disorder, or substance use.

This description matches the option that emphasizes dissatisfaction with sleep quantity or quality, plus difficulty with sleep initiation/maintenance or early morning awakening, occurring three or more nights per week for three months, causing distress or impairment, and not due to another condition. That alignment with duration, frequency, impairment, and exclusion of other causes is why this is the best description of insomnia disorder.

The other choices don’t fit: having naps and daytime sleepiness points to excessive daytime sleepiness rather than a primary insomnia pattern; one night of symptoms doesn’t meet the duration criterion; and sleep terrors with amnesia are parasomnias, not insomnia.