Nightmare disorder

This code represents a sleep-wake disorder characterized by recurrent episodes of extremely dysphoric and well-remembered dreams that typically involve threats to survival, security, or physical integrity. These nightmares usually occur during the second half of the major sleep episode and lead to significant distress or impairment in social, occupational, or other important areas of functioning.

Use this code when documentation clearly indicates a diagnosis of nightmare disorder, as defined by diagnostic criteria such as those in the DSM-5. This typically involves frequent, vivid, and disturbing dreams causing significant distress or functional impairment, and not attributable to another mental disorder, substance use, or another medical condition.

• Differentiate from other sleep disorders like night terrors (F51.8) which involve abrupt awakenings with intense fear and autonomic arousal, but typically no dream recall.
• Ensure documentation specifies the nightmares are recurrent and cause clinically significant distress or impairment.
• Code any co-occurring mental health conditions or medical conditions that may contribute to or exacerbate the nightmare disorder.