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Enuretic children have a higher variability in REM sleep when comparing their sleep parameters with nonenuretic
Ellen Collier1, Carolina Varon2, Sabine Van Huffel2
1Department of Urology, UZ Leuven, Katholieke Universiteit Leuven, Leuven, Belgium.
Insights
Children with nocturnal enuresis (bedwetting) exhibit greater variability in REM sleep. During wet nights, enuretic children experience less efficient sleep and increased restlessness compared to controls.
Area of Science:
- Pediatric Sleep Medicine
- Urology
- Biomedical Engineering
Background:
- Nocturnal enuresis, or bedwetting, is common in children.
- Parents often perceive enuretic children as deep sleepers, but objective sleep differences remain unclear.
- Understanding sleep patterns in enuretic children is crucial for effective management.
Purpose of the Study:
- To investigate sleep parameter and heart rate variability (HRV) differences between enuretic and control children.
- To utilize wearable sleep trackers for objective, home-based sleep assessment.
- To explore potential correlations between sleep disturbances and nocturnal enuresis.
Main Methods:
- A 14-day sleep study using Fitbit Charge 2 wearable devices in 21 enuretic and 18 control children (ages 6-12).
- Measurement of nocturnal urine production alongside sleep parameters and heart rate variability (HRV).
- Statistical analysis using the Kruskal-Wallis test to compare groups.
Main Results:
- Enuretic children displayed significantly higher variability in REM sleep duration across nights (P=.0209).
- A trend towards fewer awakenings was observed in enuretic children, though not statistically significant (P=.1161).
- During wet nights, enuretic children showed higher autonomic activity, reduced sleep efficiency, and increased restlessness compared to their dry nights and controls.
Conclusions:
- Enuretic children exhibit greater variability in REM sleep compared to non-enuretic peers.
- Wet nights in enuretic children are associated with poorer sleep efficiency and heightened restlessness.
- Wearable sleep trackers provide valuable insights into the sleep characteristics of children with nocturnal enuresis in their natural environment.
Purpose:
That children with nocturnal enuresis ("bedwetting") are deep sleepers is a fact that their parents often state when asking for advice. However, until today no clear difference in sleep has been observed between children who do and do not wet the bed. This study investigates the difference in sleep parameters and heart rate variability (HRV) between enuretic and control children in their home setting by using a wearable sleep tracker during a long observation period.
Methods:
Twenty-one enuretic and 18 control children, aged 6 to 12 years old, slept with a wearable sleep tracker device, a Fitbit Charge 2, for 14 consecutive days. In addition, nocturnal urine production (voided volumes and/or weight of the diaper) were measured. The HRV was calculated using the standard time and frequency domain parameters. The Kruskal-Wallis test was applied to evaluate the differences in the sleep and HRV parameters between both groups.
Results:
Compared with healthy controls, enuretic children showed a higher standard deviation (P = .0209) of minutes spent in rapid eye movement (REM) sleep among the different nights. In addition, they showed the tendencies to fewer awakenings (P = .1161), although this was not significant. Analyzing the wet nights of the enuretic children, they showed higher autonomic activity, lower sleep efficiency and a higher restlessness compared with their dry nights and to the control group.
Conclusion:
This 2-weeks sleep-study, using a wrist-worn sleep tracker device Fitbit Charge 2, in the normal home environment has shown that enuretic children have a larger variation in their REM sleep and sleepless efficiently during a wet night when compared with non-bedwetting children.
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