Recognition of shift-work disorder in primary care.

To recognize shift-work disorder (SWD), primary care physicians can screen for persistent excessive sleepiness (ES) and insomnia in patients who work night or rotating shifts. If SWD is suspected, a differential diagnosis should be generated, as ES and insomnia are commonly associated with other morbidities. Ask patients about symptoms of other common sleep/wake disorders, such as obstructive sleep apnea and periodic limb movement disorder. The Epworth Sleepiness Scale is a useful tool for subjectively evaluating ES.