Investigating chronic tiredness

A patient presents with chronic tiredness, despite sleeping 10 hours a night. What are your next steps?

Sam is a 26-year-old male who works as a sales representative, driving between multiple work sites.


He presents with an eight-year history of chronic tiredness, which has become more pronounced in the past four years. His wife reports that Sam snores, but it does not keep her awake.

Sam usually goes to sleep at 8pm and wakes at 6am. On weekends, he often sleeps until 10am.

However, he always wakes feeling exhausted and feels sleepy during the day, particularly when he is not active. He often dozes off in work meetings, while watching TV or when he is at the cinema.