Evaluation of the sleepy patient

Inefficient sleep leading to excessive daytime sleepiness is a common complaint encountered by GPs and sleep physicians. Common causes of excessive daytime sleepiness include circadian rhythm disorder/shiftwork, sleep apnoea syndrome, psychiatric disorders, restless leg syndrome, medication effect, narcolepsy and idiopathic hypersomnia.

This short review discusses the available objective and subjective testing measures in office evaluation of sleepy patients, predominantly in the primary care setting.

Beyond affecting patients' quality of life, mood and functionality, excessive sleepiness can become a public health concern when affecting critical job holders. Therefore, a clear understanding of its importance and applying current standards in evaluating patients with such a complaint are of great necessity. Apart from the clinical assessments, including a thorough history taking and physical examination, measures to assess sleepiness and ability to maintain wakefulness are available.