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Published on: October 2, 2019
Sleep Parameters and Quality of Life in Children with Monosymptomatic Nocturnal Enuresis: Association, Prediction and
Leticia Soster1, Renatha Rafihi-Ferreira2, Simone Fagundes1
1Pediatric Division, Hospital das Clínicas, University of São Paulo, São Paulo 01246-903, Brazil.
Insights
Monosymptomatic nocturnal enuresis (MNE) impacts children's quality of life. Sleep disruptions, like microarousals, negatively affect physical and social well-being, while stable N2 sleep supports it.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Quality of Life Research
Background:
- Monosymptomatic nocturnal enuresis (MNE) is often underestimated, despite its significant impact on children's quality of life.
- Understanding the interplay between sleep patterns and quality of life is crucial for effective MNE management.
Purpose of the Study:
- To investigate the relationship between polysomnography-derived sleep parameters and quality of life in children diagnosed with MNE.
- To identify specific sleep variables that predict quality of life domains in pediatric enuresis.
Main Methods:
- Polysomnography was conducted on 44 children (aged 8-12) with MNE.
- Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL).
- Multiple linear regression and moderation analyses were employed to examine sleep variables' impact on PedsQL scores.
Main Results:
- Increased microarousals correlated with lower physical and social functioning scores.
- A higher percentage of N2 sleep was associated with improved social functioning and school performance.
- N2 sleep percentage moderated the negative effect of arousals on social functioning, exacerbating the impact.
Conclusions:
- Sleep continuity and N2 sleep stability are vital for the quality of life in children with MNE.
- The study highlights the complex relationship between sleep architecture and perceived well-being in pediatric enuresis.
- Findings emphasize the need to consider sleep disturbances in the holistic management of MNE.
Abstract:
Although often considered benign, monosymptomatic nocturnal enuresis (MNE) can significantly affect various domains of children's quality of life. This study aimed to investigate the relationship between polysomnography-derived sleep parameters and quality of life in children with MNE. Forty-four participants aged 8-12 years, with a diagnosis of MNE, underwent polysomnography and completed a quality of life questionnaire (PedsQL). Multiple linear regressions were used to assess the role of sleep variables in predicting four PedsQL domains. Moderation analysis was also performed to evaluate whether the N2 sleep percentage influenced the relationship between arousals and PedsQL. A higher frequency of microarousals predicted lower scores in the physical (B = -3.28, p = 0.01) and social (B = -3.50, p = 0.004) domains. A higher N2 sleep percentage was associated with better social (B = 0.69, p = 0.03) and school functioning (B = 0.88, p = 0.03). Moderation analysis revealed that N2 sleep amplified the negative impact of arousals on the social domain, particularly when the N2 sleep percentage was one standard deviation above the mean (B = -4.31, p < 0.001). The findings underscore the importance of sleep continuity and N2 stability for the quality of life of children with MNE. These results demonstrate the complex interaction between sleep and quality of life in pediatric enuresis.
