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Sleep of primary enuretic children and controls
Gaby Bader1, Tryggve Nevéus, Sonja Kruse
1Department of Clinical Neuroscience, Sahlgren's University Hospital, Gothenburg, Sweden. baderg@mednet.gu.se
Insights
Children with primary nocturnal enuresis have normal sleep patterns, but show signs of autonomic arousal before bedwetting. This suggests underlying physiological responses rather than sleep disturbances in enuresis.
Area of Science:
- Pediatric Sleep Medicine
- Urology
- Neurophysiology
Background:
- Primary nocturnal enuresis is common in children.
- Understanding the sleep characteristics of enuretic children is crucial for effective management.
Purpose of the Study:
- To investigate and compare the sleep patterns of children with primary nocturnal enuresis and healthy controls.
- To identify any polysomnographic differences, including body movements and nocturnal micturition events.
Main Methods:
- Polysomnography was conducted in the children's homes.
- 21 children with primary nocturnal enuresis and 6 age-matched controls participated.
- Standard sleep features, body movements, and nocturnal voiding were recorded.
Main Results:
- Enuretic children exhibited normal polysomnographic sleep architecture, similar to controls.
- Significant differences included longer time in bed and more sleep cycles in enuretic children.
- Autonomic arousal signs, like tachycardia and EEG arousal, preceded micturition in some enuretic children.
Conclusions:
- Sleep in children with primary nocturnal enuresis is polysomnographically normal.
- Evidence suggests autonomic arousal preceding micturition events in enuretic children.
Study Objectives:
To look for differences between the sleep of enuretic children and controls.
Design:
In addition to standard polysomnographic features, body movement data and nocturnal micturitions were recorded.
Setting:
The children's homes.
Participants:
Twenty-one children with primary nocturnal enuresis and 6 controls of similar age.
Interventions:
None.
Results:
Sleep of the enuretic children did not diverge to a large extent from that of the controls. The only significant differences were that the enuretic children spent a slightly longer time in bed and had an increased number of sleep cycles. Although there was a trend for an increased number of short movements in enuretics, this was not statistically significant. Fifteen children experienced enuresis during the recording night. Micturition occurred during the first half of the night for most of the children and was not linked to any specific sleep stage. Children who voided during rapid-eye movemnt (REM) sleep were found to have more REM sleep than the others. Tachycardia was often seen to precede the enuretic event. In some subjects a short EEG arousal was observed before micturition.
Conclusions:
Sleep of enuretic children is polysomnographically normal, but the children exhibit signs of autonomous arousal prior to micturition.