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Sleep apnea in children with refractory monosymptomatic nocturnal enuresis

Ashraf El-Mitwalli1, Adel Salah Bediwy2, Ashraf Ahmed Zaher1

  • 1Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Nature and Science of Sleep
|March 21, 2014
PubMed

Insights

Children with refractory nocturnal enuresis (NE) have a higher prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS). More severe OSAHS in these children is linked to more frequent bedwetting episodes.

Area of Science:

  • Pediatric Sleep Medicine
  • Urology

Background:

  • Nocturnal enuresis (NE) in children is often associated with deep sleep and high arousal thresholds.
  • Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common childhood condition.
  • The co-occurrence and relationship between NE and OSAHS require further investigation.

Purpose of the Study:

  • To determine the prevalence of OSAHS in children with refractory NE.
  • To investigate if OSAHS severity correlates with the frequency of bedwetting in children with NE.

Main Methods:

  • A study group of 43 children with refractory monosymptomatic NE and a control group of 30 children (aged 6-12) were recruited.
  • Participants underwent neurological examination; NE patients had polysomnography and X-rays to rule out spina bifida.

Main Results:

  • Children with refractory NE showed a significantly higher prevalence of OSAHS compared to controls (P<0.0001).
  • OSAHS was diagnosed in 25 out of 43 NE patients (mild: 3, moderate: 12, severe: 11).
  • A statistically significant association was found between severe OSAHS and a higher frequency of bedwetting (P=0.003).

Conclusions:

  • Refractory NE in children is significantly associated with a higher prevalence of OSAHS.
  • The severity of OSAHS directly correlates with the frequency of bedwetting in affected children.
  • No sex differences were observed in the prevalence of OSAHS among children with NE.
Abstract

Keywords:
OSAnocturnal enuresisrefractory

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