Insomnia Leave bedroom when not asleep Keep a sleep journal Behavioral treatments for insomnia Practice relaxation techniques Restrict time awake in bed Maintain a regular sleep schedule Establish a regular wake-up time I nsomnia is a sleep disorder experienced by 12% to 20% of the general adult population. Insomnia is an inability to fall asleep and/or frequent awakenings with an inability to return to sleep. It is associated with daytime symptoms such as irritability and fatigue. The February 20, 2013, issue of JAMA includes an article about insomnia.
In caustic ingestion injury, the urgent assessment of the airway is the first priority with a definitive airway secured in those with airway compromise. In those patients with a stable airway and no clinical or radiological sign of perforation, then medical therapy should be commenced and an urgent oesophagogastroduodenoscopy (OGD) is arranged and this should take place within the first 24 h to grade the degree of injury and establish long-term prognosis. In suspected perforation, a surgical opinion should be sought. For those adults who are asymptomatic following ingestion an OGD may not be necessary; however, asymptomatic paediatric patients should be treated with more caution and a period of observation is important. Those who are at risk of developing late complications must be followed up.
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