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Abnormal sleep architecture and refractory nocturnal enuresis

Karlien Dhondt1, Ann Raes, Piet Hoebeke

  • 1Pediatric Sleep Centre, Ghent University Hospital, Ghent, Belgium. Karlien.Dhondt@ugent.be

The Journal of Urology
|August 22, 2009
PubMed

Insights

Children with refractory nocturnal enuresis often experience frequent periodic limb movements during sleep, indicating increased cortical arousability and awakenings. This challenges the notion of excessively deep sleep in these patients.

Area of Science:

  • Pediatric Sleep Medicine
  • Urology
  • Neurology

Background:

  • Nocturnal enuresis (NE) in children is often linked to theories of deep sleep and reduced arousal.
  • However, the specific sleep characteristics in children with refractory NE require further investigation.

Purpose of the Study:

  • To investigate sleep characteristics in children diagnosed with refractory nocturnal enuresis.
  • To compare sleep parameters, including periodic limb movements (PLMs) and arousal-awakenings, with age-matched controls.

Main Methods:

  • A cohort of 29 children (5-19 years) with refractory NE underwent polysomnography.
  • Sleep data, including PLMs and arousal-awakenings, were analyzed and compared to established control values.
  • Two age groups (5-9 years and 10-19 years) were analyzed separately.

Main Results:

  • A high incidence of periodic limb movements in sleep (PLMs) was observed in over 96% of patients, significantly exceeding control values.
  • Patients exhibited substantially increased total arousal-awakenings compared to controls.
  • Both PLMs and arousal-awakenings were statistically significant in the study population versus controls (p < 0.001).

Conclusions:

  • Refractory nocturnal enuresis in children is associated with a high frequency of PLMs and increased cortical arousability.
  • These findings suggest that sleep disturbances, rather than simply deep sleep, play a crucial role in refractory NE.
  • Further research into sleep architecture and arousal mechanisms is warranted for this population.
Abstract

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