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Enuresis in children with sleep apnea
1Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 19104, USA. brooksl@email.chop.edu
The Journal of Pediatrics
|May 21, 2003
Summary
Children with sleep apnea (Respiratory Disturbance Index >1) have a higher risk of bedwetting (enuresis) than those with normal breathing during sleep. This suggests a link between sleep disordered breathing and enuresis in children.
Area of Science:
- Pediatrics
- Sleep Medicine
- Urology
Background:
- Nocturnal enuresis is a common concern in children.
- Sleep disordered breathing (SDB) is increasingly recognized as a potential contributing factor to various pediatric health issues.
Purpose of the Study:
- To investigate the relationship between the severity of sleep apnea, measured by the Respiratory Disturbance Index (RDI), and the presence and severity of nocturnal enuresis in children.
- To determine if children with SDB are at a higher risk for enuresis.
Main Methods:
- A cohort of children aged 4 years and older referred to a sleep center for suspected SDB were evaluated.
- Participants underwent overnight polysomnography (PSG) to determine the RDI.
- Enuresis status and frequency were assessed through direct questioning.
Main Results:
- Enuresis was more prevalent in children with suspected SDB compared to literature controls.
- Children with an RDI greater than 1 had a significantly higher prevalence of enuresis (47%) compared to those with an RDI of 1 or less (17%).
- Frequent enuresis was also significantly more common in children with an RDI greater than 1 (32%) versus those with an RDI of 1 or less (14%).
Conclusions:
- There is a high prevalence of enuresis among children with suspected sleep-disordered breathing.
- Children with an RDI greater than 1 are at an increased risk for enuresis.
- The findings suggest that obstructive sleep apnea may influence arousal responses, bladder pressure, or urinary hormone secretion, contributing to enuresis.