On the other hand, classification for research purposes benefits from a narrower definition of disorders or symptoms for higher homogeneity research studies often treat these as dichotomous variables (i.e., either present or absent). This is particularly difficult for disorders that present with a wide spectrum of possible symptoms. Ideally, any classification for clinical purposes must be sensitive enough to detect most people who have the condition, yet specific enough to exclude most of those who do not. This underscores the impact and importance of developing valid and concordant classification systems. This wide variance in prevalence rates stems from the use of different classification systems defined by various professional bodies. The global prevalence of insomnia symptoms is about 30%−35% the prevalence of insomnia disorder ranges from 3.9% to 22.1%, depending on the diagnostic criteria used ( 2). Insomnia is the most common sleep disorder in the adult population and poses a major public health concern worldwide ( 1). The continual evolution of insomnia nosology highlights that much remains to be learned about these conditions all current diagnostic classification systems are best regarded as “works in progress.” Nevertheless, refinement and convergence of classification approaches is essential to standardizing insomnia research, diagnosis, and treatment. Data-driven insomnia subtyping suggests a promising new approach in deriving empirically based subtypes conversely, the transdiagnostic perspective proposes the elimination of categorical distinctions in favor of finding common processes underlying all psychiatric disorders. In ongoing research efforts, the quest for insomnia biomarkers has not thus far yielded clinically deployable breakthroughs. Current insomnia definitions include frequency and duration criteria to operationalize these diagnoses, while the diagnostic criterion of nonrestorative sleep has been eliminated (with some controversy). Additionally, the historical multitude of insomnia subtypes has gradually consolidated into a few core diagnoses, reflecting inadequate evidence with which to support subtyping. Over time, the emphasis in classification approaches has shifted from symptomatology to etiology to treatment implications. Despite their divergent origins, these classification systems have converged to nearly identical contemporary insomnia definitions. Three major classification systems for insomnia are the International Classification of Sleep Disorders, the International Classification of Diseases, and DSM. In the present study, the investigators traced the evolution of insomnia disorder across classification systems, contemplated the empirical basis for its current definitions, and surveyed ongoing research efforts that may clarify insomnia nosology in the future. However, the definition of insomnia disorder has varied across major classification systems and changed over time. Insomnia is the most common sleep disorder in the adult population.
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