Tiredness History

Question 1

Red flags for tiredness

Answer 1

Unexplained weight loss
Sleep disturbance
Other symptoms of depression
Fever

Question 2

Sleep

Answer 2

Ask detailed questions – not just “do you sleep well?”
What time to you go to bed?
What to do you go to sleep?
Do you wake during the night?
What time do you wake in the morning?
What time do you get out of bed in the morning?
What do you do just before bed?
Do you fall asleep during the day?

Question 3

Social history

Answer 3

Work – how is work? Do you work long hours? Do you enjoy your job? What are your career plans? Bullying at work?
Home life – how is home life? Do you have any children? Do you have a supportive partner? How are your children / partner / parents?
Recent bereavement?
Recent relationship breakdown?
Recently retired?
Why do you think you are tired?

Question 4

Diet

Answer 4

Don’t just ask “what is your diet like?” Or “do you have a good diet?” Be specific
“Are you following a particular specialist diet?”
Take me through a typical day from when you get up to when you go to bed – tell me everything you eat and drink”

Question 5

Medical questions

Answer 5

Menstrual history
Sexual activity / sexual dysfunction
Any regular medications? Any OTC medications?
Recent history of trauma or surgery
Any recent infections?
Any fevers?
Any chronic pain?
Bowel habit
Specific illness questions (if suspected), e.g.:
Hypothyroidism – weight gain, skin changes, hair changes, mood changes
Sleep apnoea – falling asleep during the day, awaking with a headache, aka wing feeling untested, history of snoring
Heart failure – SOB on exertion, ankle swelling, history of heart disease, cough

Question 6

Psychological

Answer 6

Do you feel depressed?
Any history of mental health disorders
Ask yourself – Is this patient depressed?