📝 What is it?
The DSM-5 Level 2 Sleep Disturbance measures sleep quality in adults (there is also a child version). Sleep is super important to mental health!
It is most often used to monitor a client's sleep quality week over week. Some clinicians use it weekly and some use it biweekly.
It contains 8 questions with a 5-point Likert scale and typically takes 1-2 minutes to complete.
📸 Sample screenshot:
🔎 More info about this measure:
The "Level 2" refers to a group of "follow-up" measures recommended by the DSM-5 that investigate specific symptoms that appeared mild or more severe on a cross-cutting screener.
The American Psychiatric Association (APA) says this about these Level 2 measures: "The APA is offering a number of “emerging measures” for further research and clinical evaluation. These patient assessment measures were developed to be administered at the initial patient interview and to monitor treatment progress. They should be used in research and evaluation as potentially useful tools to enhance clinical decision-making and not as the sole basis for making a clinical diagnosis. Instructions, scoring information, and interpretation guidelines are provided; further background information can be found in DSM-5."
😴 What is a sleep disturbance?
Sleep disturbances is a group of conditions that prevent people from sleeping well on a regular basis. They may affect the quality, timing, or duration of sleep and also the ability to function properly when the person is awake.
Sleep is a vital and basic human need. It is very important to physical and mental health. It can impact mood, attention, school/work performance, memory, relationships, and more.
Many people do not get enough sleep!
There are normal sleep disturbances such as stress or jet lag as well as diagnosable sleep disorders such as narcolepsy, sleep apnea, or insomnia.
Sleep disturbances causes could be physical (back pain), mental (depression), environmental (light and noise), drugs (prescription, alcohol, or caffeine), and even genetics or aging.
There are many things people can do to improve sleep. Psychotherapy can help relieve stress or other issues that impact sleep. Medication, supplements, exercise, sleep hygiene, and much more could also help.
For more info about sleep, check out this informative article from The Cleveland Clinic.
📉 Scoring:
The DSM-5 Level 2 Sleep Disturbance contains 8 questions scored on a 5-point Likert scale from 1-5. Four of the questions are forward-scored and the other four are reverse-scored. Total scores range from 8 to 40. Higher scores are associated with greater severity of sleep disturbance. See below for a table of different interpretations.
Score | Severity |
0-25 | None to slight |
25-29 | Mild |
30-37 | Moderate |
38-40 | Severe |
ℹ️ Summary:
Focus Area: Sleep
Overview: The DSM-5 Level 2—Sleep Disturbance looks at an adult's issues with sleep disturbance. It is helpful in tracking sleep disturbance symptoms over time.
Total number of items: 8
Administration: Self-report
Standardized cadence: Weekly
Estimated completion time:
Supported subscales: None
Age range: 18+
Scoring and interpretation: Answers are scored on a 5-point Likert scale from 1 for "Never" to 5 for "Always." Scores are summed and total scores range from 8 to 40. Higher scores are associated with higher levels of sleep disturbance. See table above for clinical cutoffs.
Additional information: