Enuresis and Obstructive Sleep Apnea in Children
Nocturnal enuresis is a common problem, affecting an estimated 5 to 7 million children in the United States alone and occurring three times more often in boys than in girls. Nocturnal enuresis is clinically and pathogenetically a heterogeneous disorder. A significant correlation between enuresis and obstructive sleep-disordered breathing has been described in the last decade, with a high prevalence of enuresis in those patients. It seems clear that increased upper airway resistance during sleep manifesting either as habitual snoring (HS) or as polysomnographically documented obstructive sleep apnea syndrome (OSA), increases the risk of enuresis. Most importantly, after successful treatment of the respiratory disorder during sleep, bedwetting can be reduced or even eliminated. The goal of this chapter is to review the epidemiology, etiology, pathophysiology (specially the link with sleep disordered breathing), treatment and future areas of research for nocturnal enuresis.
KeywordsObstructive Sleep Apnea Obstructive Sleep Apnea Syndrome Atrial Natriuretic Peptide Detrusor Overactivity Nocturnal Enuresis
- 19.Nijman RJ. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children. J Urol. 2004;63(3 Suppl 1):45–50.Google Scholar
- 36.Glazener CM, Evans JH. Desmopressin for nocturnal enuresis. Cochrane Database Syst Rev. 2002;(3):CD002112Google Scholar
- 38.Leiberman A, Stiller-Timor L, Tarasiuk A, Tal A. The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective. Int J Pediatr Otorhinolaryngol. 2006 Oct;70(10):1675–82. Epub 2006 Jul 18.Google Scholar
- 40.de Groat WC, Booth AM. Physiology of the urinary bladder and urethra. Ann Intern Med. 1980;92(Pt 2):312–5.Google Scholar
- 44.Fujiwara J, Kimura S, Tsukayama H, et al. Evaluation of the autonomic nervous system function in children with primary monosymptomatic nocturnal enuresis power spectrum analysis of heart rate variability using 24-h Holter electrocardiograms. Scand J Urol Nephrol. 2001;35(5):350–6.PubMedCrossRefGoogle Scholar