A patient comes in because of a chief complaint listed as fatigue. When asked by the doc to describe the problem the patient starts from the top; "Well doc, I go to bed at a decent hour, and get a good nights sleep. I wake up feeling completely refreshed, and ready to start the day. I shower, get dressed, have breakfast and a cup of coffee then continue on my way to work. Then, everyday, without exception, I suddenly become exhausted. I fight sleep the entire drive to work. The entire day at work. And then even into the evening, then before bed I start to feel a little better, but then it's bedtime again. I have had to pull over because of falling asleep at the wheel. My daughter even drives me to work now because I am too nervous to drive myself." So, the doc runs through the whole gamut of questions such as: Do you notice yourself waking up at night? Do you snore? Are you falling asleep or losing consciousness? Do you have a history of seizures? Does you have a family history of sleep disorders? No, no, no and no.
So the doc movies on to what medications are you taking? In the extensive list of medications, the patients mentions Ambien (a pill solely meant to aid in sleep). So the doc asks, are you taking the Ambien a full 8-10 hours before you go to bed? And the patient's reply: "Well, of course not doc! I take it in the morning with all my other pills."