When a patient complains of job-related fatigue or chronic fatigue, a critical component of his or her evaluation is to determine if the fatigue is secondary to the patient’s sleep schedule, or to a sleep disorder, or to a circadian rhythm disorder. This chapter provides the reader with a description of how that evaluation should proceed and what tests, studies, and procedures to employ.
First, this chapter describes how to determine if the patient is obtaining adequate sleep or is chronically sleep deprived. Secondly, it describes how to determine if a sleep disorder is present. Finally, it explains how to determine if a circadian rhythm disorder is the cause of chronic fatigue. For each of these, the chapter will discuss scales, diaries, sleep logs, and actigraphy for ruling in or out a diagnosis with a reasonable degree of certainty.
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