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Formal diagnostic systems (DSM-IV, ICSD, and ICD-10) do not provide adequate quantitative
criteria to diagnose insomnia. This may not present a serious problem in clinical
settings where extensive interviews determine the need for clinical management. However,
lack of standard criteria introduce disruptive variability into the insomnia research
domain. The present study reviewed two decades of psychology clinical trials for insomnia
to determine common practice with regard to frequency, severity, and duration criteria
for insomnia. Modal patterns established frequency (> or =3 nights a week) and duration
(> or =6 months) standard criteria. We then applied four versions of severity criteria
to a random sample and used sensitivity-specificity analyses to identify the most
valid criterion. We found that severity of sleep onset latency or wake time after
sleep onset of: (a) > or =31 min; (b) occurring > or =3 nights a week; (c) for > or
=6 months are the most defensible quantitative criteria for insomnia.