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And sleep hygieneongoing monitoring and counselingspecific diagnosis noconsider consultationadvise patient about coping maintain regul follow upinstruct re modifiable lifestyle factorsprovide continued support of the patient. Monitor changes in symptoms. Repeat focused physical exam at each visit. Remain alert for onset of depression. Avoid overuse of repeated diagnostic testing. Request consults when needed. Encourage activity over inactivity. Reinforce need for adequate sleep. Figure general approach to patients with fatigue. Osa obstructive sleep apnea rls restless leg syndrome. Page fat i g u e sleepiness how likely e you to doze off or fall asleep as opposed to just feeling tired in the following situations never likelyfigure questions differentiat ing between sleepiness and fatigue. Adapted from s bailes.
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