Chronic fatigue

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30 Nov 2016 - General

Before I started subspecialty training, I worked for a few months as a general practitioner in one of the hospitals in Manila. I have encountered some patients who come in for consult due to complaints of chronic fatigue. A lot of them would describe that they still feel tired even after going on a vacation, or even after getting adequate amounts of sleep. History and PE are usually unremarkable except for some patients expressing that they are too stressed at work. I'd like to ask how other healthcare providers in the community would approach the diagnosis to these kinds of patients. What questions do you ask and what tests do you request? Personally, the first differential diagnosis that I always consider is obstructive sleep apnea and I always ask if they snore. For other members of the community, feel free to share your thoughts and experiences on these types of patients.