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Sleep disturbance and bladder dysfunction in enuretic children with treatment failure: fact or fiction?
1Division of Paediatric Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, China.
Insights
Sleep disturbances and bladder dysfunction are common in children with persistent nocturnal enuresis (bedwetting). These issues are particularly prevalent in those who do not respond to initial treatments, indicating complex underlying factors.
Area of Science:
- Pediatrics
- Urology
- Sleep Medicine
Background:
- Monosymptomatic nocturnal enuresis (MNE) is common in children.
- Persistent MNE after treatment failure suggests underlying complexities.
- Sleep disturbances and bladder dysfunction are potential contributing factors.
Purpose of the Study:
- To investigate the prevalence of sleep disturbances and bladder dysfunction in children with MNE.
- To identify patterns of these conditions in treatment-resistant enuretic children.
- To explore the relationship between urodynamics, sleep, and enuresis.
Main Methods:
- Studied 25 children with persistent monosymptomatic nocturnal enuresis (>4 wet nights/week) after treatment failure.
- Utilized daytime cystometry, nighttime polysomnography with simultaneous cystometry, and urine output monitoring.
- Analyzed data to identify distinct patterns based on sleep, bladder function, and urodynamics.
Main Results:
- None of the studied children had nocturnal polyuria.
- Five distinct patterns were identified based on sleep disturbance and bladder dysfunction.
- Abnormal daytime urodynamics were observed in some patterns.
- Sleep disturbances and bladder dysfunction are common, especially in treatment-resistant cases.
Conclusions:
- Sleep disturbances and bladder dysfunction are frequently observed in children with monosymptomatic nocturnal enuresis.
- These comorbidities are particularly significant in children who have not responded to treatment.
- Further investigation into these associated conditions is warranted for effective management.
Abstract:
To document the occurrence of sleep disturbance and bladder dysfunction in enuretic children, 25 children (21 boys, 4 girls, mean age 9.9 years) with monosymptomatic nocturnal enuresis were studied. All children had significant enuretic symptoms (> 4 wet nights per week) which persisted after treatment failure. The investigation protocol included cystometry during the day, simultaneous polysomnographic and cystometric monitoring during the night and recording of diurnal and nocturnal urine output. None of the patients had nocturnal polyuria. According to the presence or absence of sleep disturbance and/or bladder dysfunction, five different patterns could be recognized. These patterns were grouped as having normal and abnormal daytime urodynamics. In conclusion, sleep disturbances and bladder dysfunction are common among enuretic children, especially those who fail to respond to treatment.