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Sleep fragmentation and periodic limb movements in children with monosymptomatic nocturnal enuresis and polyuria

Karlien Dhondt1, Charlotte Van Herzeele, Sanne Patrick Roels

  • 1Pediatrics, Department of Child Neurology and Metabolism, Pediatric Sleep Center, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, karlien.dhondt@ugent.be.

Pediatric Nephrology (Berlin, Germany)
|February 12, 2015
PubMed

Insights

Children with nocturnal enuresis (NE) and polyuria experience increased periodic limb movements in sleep (PLMS) and cortical arousals. These sleep disturbances were not linked to specific enuretic parameters, suggesting a common underlying cause possibly involving the autonomic nervous system.

Area of Science:

  • Pediatric Sleep Medicine
  • Urology
  • Neuroscience

Background:

  • Nocturnal enuresis (NE) is associated with sleep fragmentation and periodic limb movements in sleep (PLMS).
  • Understanding the link between NE, polyuria, and sleep disturbances is crucial for effective treatment.

Purpose of the Study:

  • To investigate the association between monosymptomatic NE with polyuria and the frequency of PLMS and cortical arousals.
  • To explore correlations between enuretic parameters (fluid intake, bladder volume, wet nights, polyuria frequency) and sleep disturbances.

Main Methods:

  • Polysomnography was conducted on 30 children with monosymptomatic NE and polyuria.
  • Enuretic parameters were assessed using diaries, forced drinking tests, uroflowmetry, and ultrasound.
  • Sleep data (PLMS, cortical arousals) were compared to a control group with refractory NE.

Main Results:

  • A positive association was found between the PLMS index and both the arousal index and awakening index (p < 0.001).
  • No significant correlation was observed between sleep parameters and enuretic parameters.
  • Children with refractory NE exhibited a significantly higher PLMS index (p < 0.001).

Conclusions:

  • Increased PLMS and cortical arousals are present in children with monosymptomatic NE and polyuria.
  • These sleep disturbances are not directly associated with specific enuretic parameters.
  • A common underlying mechanism, potentially involving the autonomic and dopaminergic systems, is hypothesized to drive these comorbid conditions.
Abstract

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