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Published on: October 2, 2019
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Non-REM Sleep Instability in Children With Primary Monosymptomatic Sleep Enuresis
Leticia Azevedo Soster1, Rosana Cardoso Alves1, Simone Nascimento Fagundes2
1Neurology Division, Hospital das Clínicas, São Paulo University (HC/FMUSP), São Paulo, Brazil.
Summary
Children with sleep enuresis exhibit disrupted sleep microstructure, specifically reduced arousal during deep sleep. This study utilized cyclic alternating pattern (CAP) analysis to reveal a higher arousal threshold in these children.
Area of Science:
- Pediatric Sleep Medicine
- Neurophysiology
- Sleep Disorders
Background:
- Sleep enuresis is a common childhood sleep disturbance.
- Parental reports of deeper sleep in enuretic children lack objective confirmation.
- Previous studies show disturbed sleep but no clear neurophysiological link to low arousal.
Purpose of the Study:
- To investigate sleep microstructure in children with sleep enuresis.
- To analyze sleep patterns using cyclic alternating pattern (CAP) analysis.
- To explore the neurophysiological basis of arousal in pediatric sleep enuresis.
Main Methods:
- Recruited 49 children (27 with enuresis, 22 controls).
- Conducted clinical evaluations and full-night polysomnography.
- Excluded subjects with neurological, respiratory, or renal conditions.
Main Results:
- Enuretic children showed decreased stage N3 sleep percentage.
- Increased CAP rate and A1 index during stage N3 sleep were observed.
- Reduced A2% and A3% and phase indexes in stage N3 sleep indicated decreased arousability.
Conclusions:
- Sleep microstructure is significantly disrupted in children with sleep enuresis.
- Findings support a hypothesis of a higher arousal threshold in enuretic children.
- Altered CAP patterns suggest impaired arousal mechanisms and increased sleep pressure.
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