The effectiveness of music-based sensory activation solutions (SAS) method in patients with treatment-resistant...

Although nocturnal enuresis is a somatically benign condition, it can pose long-term psychosocial risks if left untreated. Treatment efforts continue, particularly for treatment-resistant nocturnal enuresis. We aimed to evaluate the effectiveness of music-based sensory activation solutions (SAS) in treating enuresis in patients who have not responded to treatment options listed in guidelines.

In this prospective study, patients aged 6-17 years who were referred from departments other than the child psychiatry outpatient clinic with complaints of nocturnal enuresis were included. Patients were divided into two groups: a study group and a control group. Patients received at least two or more of the following treatment modalities for a minimum of 6 months: alarm therapy, desmopressin, anticholinergic, combination therapies, standard urotherapy, biofeedback therapy, and pelvic floor rehabilitation. Patients who received treatment for at least 6 months and did not respond were included. The Sensory Activation Solutions (SAS) method aims to synchronize brain waves and promote neuroplasticity by using specific frequency, rhythm, and melodic features of music. The monthly dry duration (number of dry nights in 30 days) of the patients before the start of the SAS method was recorded, and the monthly dry duration was recorded again during the program and 1 month after the end of the program with a follow-up examination. The SAS method was planned to last for 3 weeks (21 days). An audio program was applied with over-ear wireless headphones.

There were 28 patients in both groups. It was found that there was no significant difference between the study patients and the control group in terms of age and gender group distributions (χ²(10) = 9.67, p = 0.470), (χ²(1) = 0.35, p = 0.554). In the comparison made between the period before the SAS application and 1 month after the application, a significant decrease was found in the frequency of bedwetting in children (Z = -4.41, p < 0.001).

Multidisciplinary and individualized approaches are essential in cases of treatment-resistant nocturnal enuresis. SAS method may be a non-invasive and safe treatment option for cases of resistant enuresis. There is a need for large series investigating the long-term outcomes of treatment protocols that address physiological, behavioral, and psychosocial components together, supported by innovative neuromodulation methods, such as SAS.