Sleepiness and tiredness for whole day

A 42-year-old male complained of sleepiness for the whole day. He is not able to concentrate on his work. His wife complains he sleeps for the whole day, he sleeps even on chair while sitting. This complaint persists since 3-4 weeks. He is eating well and feels fine except for tiredness for the whole day. He sleeps early at night still wakes up late. He doesn't smoke and drinks rarely. Blood report: Hb – 8.1 g/dL MCV – 88 fL WCC – 260 x 110 Hct – 0.30/L Basophils – 1.09 x 107/L Neutrophils – 184 x 107/L Eosinophils – 3.9 x 109/L Myeloblasts – 8.2 x 109/L Random blood glucose – 4.9 mmol/L Can you tell what is the cause for his tiredness?



Needs further investigation and evaluation to conclude particularly thyroid profile, depression ,past history of medication ,and present history of food ingestion some occupational environment and reassurance and counciling required in such cases family and social history plays an important role in conclusion. Psychiatrist opinion can be useful.

As HB - 8.1 mg /dl which is rare in males , it needs,investigations. Get a thyroid profile done to rule out hypothyroidism. Get his s.vitamin D levels tested . Also get his breath analysis done for alcohol levels as Auto - brewery syndrome is a rare possibility.

Possible cause of hyper somnolence in this case Anemia,,needs investigations Obstructive Sleep Apnoea ,ask for history of snoring ., sleep lab studies Hypothyroidism ,thyroid prfile needed Pickwickian syndrome

Please note for thyroid profile, any mental stress, cardiac abnormalities , vit B12 deficiency & low Hb count may also be one of cause .

Can go for STOP BANG criteria which will help to identify whether patient has OSA or not. What about BMI? Any past medical history ?

-Please look for the cause of anemia as Hb is 8.1 and treat the same. Serum ferritin TIBC,folate -Look for LDL,HDL,VLDL too

Post more details about his weight, history of snoring, HTN, Thyroid profile. Rule out OSA

Can check Thyroid function,above depression is also a cause.That has to be ruled out.

Hypersomnia Rule out other associated conditions

Also rule out depressive illness

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