Recognizing sleep disorders in a primary care setting.

As many as one third of the general population suffers from some form of sleep disorder. Although sleep disorders are widespread in society, few patients present with overt sleep complaints; they instead present with symptoms of fatigue, excessive sleepiness, and impaired waking function. Untreated sleep disorders, particularly insomnia, can lead to potentially life-threatening automobile crashes and industrial accidents. In addition, poor motor, mental, and cognitive function at home, work, and school can negatively impact a patient's quality of life. Therefore, physicians must maintain a high index of suspicion for sleep disorders whenever they see patients, and they must ask sleep-related questions during office visits for acute conditions, chronic conditions, and annual physical examinations. Today's "24/7" society experiences sleep disorders in ever-increasing numbers, and people who work shifts are at risk for developing circadian rhythm sleep disorder, particularly shift work sleep disorder. Physicians must engage their patients in a discussion of their occupations and sleeping habits in order to detect and treat sleep disorders.