Enuresis, sleep and desmopressin treatment

Area of Science:

• Pediatric Sleep Medicine
• Urology
• Pharmacology

Background:

• Primary nocturnal enuresis is a common condition in children.
• Desmopressin is a standard treatment for nocturnal enuresis, primarily acting by reducing urine production.
• The impact of desmopressin on sleep architecture in enuretic children requires further investigation.

Purpose of the Study:

• To evaluate the effects of desmopressin on sleep in children with primary nocturnal enuresis.
• To identify polysomnographic differences between children who respond and those who do not respond to desmopressin treatment.

Main Methods:

• Polysomnography was performed on 21 children with primary nocturnal enuresis before treatment.
• Desmopressin treatment was administered, and response was documented.
• Seven children underwent a second polysomnographic recording during desmopressin treatment.

Main Results:

• Desmopressin significantly increased the time between sleep onset and enuretic episodes (92 min vs. 372 min, p=0.003).
• No significant changes were observed in standard polysomnographic variables with desmopressin.
• Desmopressin responders (n=10) exhibited longer total sleep time (455 min vs. 408 min, p=0.04) and a higher percentage of rapid eye movement (REM) sleep (27.4% vs. 18.2%, p=0.004) compared to non-responders (n=10).

Conclusions:

• Desmopressin effectively delays bladder emptying in enuretic children without major adverse effects on sleep architecture.
• Children who respond to desmopressin treatment demonstrate distinct sleep patterns, characterized by more REM sleep, compared to therapy-resistant children.