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Alarm interventions for nocturnal enuresis in children
C M Glazener1, J H Evans, R E Peto
1Health Services Research Unit (Foresterhill Lea), University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK, AB25 2ZD. c.glazener@abdn.ac.uk
The Cochrane Database of Systematic Reviews
|June 14, 2003
Summary
Alarm interventions are effective for childhood nocturnal enuresis (bedwetting), showing higher success rates than desmopressin or tricyclics. Adding overlearning and avoiding penalties can further reduce relapse rates in treating this common condition.
Area of Science:
- Pediatric Urology
- Behavioral Medicine
- Sleep Medicine
Background:
- Nocturnal enuresis affects 15-20% of five-year-olds and up to 2% of young adults.
- It is a socially disruptive and stressful condition for affected children and families.
Purpose of the Study:
- To assess the effectiveness of alarm interventions for childhood nocturnal enuresis.
- To compare alarm interventions with other treatments for bedwetting.
Main Methods:
- Systematic review of randomized and quasi-randomized trials of alarm interventions.
- Searched Cochrane Incontinence Group trials register and reference lists (up to December 2002).
- Included trials comparing alarms to no treatment, behavioral methods, desmopressin, and tricyclics.
Main Results:
- Alarm interventions achieved dryness in about two-thirds of children compared to no treatment.
- Nearly half of children remained dry after treatment completion, versus almost none without alarms.
- Alarms were more effective than desmopressin and tricyclics both during and after treatment.
- Adding overlearning reduced relapse rates; penalties appeared counter-productive.
Conclusions:
- Alarm interventions represent an effective treatment for nocturnal enuresis in children.
- Alarms demonstrate superior efficacy compared to desmopressin and tricyclics, both short-term and long-term.
- Strategies like overlearning and avoiding penalties may enhance treatment outcomes and reduce relapse.
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