Incontinence and sleep disturbances in young children: A population‐based study

Abstract

Aims: Nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI), as well as sleep and behavioral problems are common in young children. The aim of this study was to analyze the association of sleep and psychological parameters for all types of incontinence in a representative sample of young children. Methods: Six hundred thirty eight (of 1161) children with a mean age of 5.9 years (50.9% boys) were assessed during their mandatory school entry examination. The participation rate was 55%. Instruments included the Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire and other clinical questions. Incontinence was diagnosed according to ICCS standards. Constipation was assessed by two questions. Results: 17.1% of children had at least one type of incontinence, 14.8% had NE, 5.0% DUI, 2.1% FI, and 4.8% were constipated. 6.7% of children had clinically relevant psychological problems. 22.7% of children had sleep problems regularly (5−7 times/week). A wide variety of sleep problems were reported. Children with incontinence were not affected by a higher rate of sleep problems. Children with NE had fewer night wakings and those with constipation fewer parasomnias. Sleep and psychological problems were significantly associated, especially in children with DUI and FI. Conclusions: Sleep and behavioral problems are common in young children. Psychological problems have a clear impact on sleep. Young children with incontinence do not have more sleep problems than continent children. Therefore, both sleep and psychological problems should be addressed in young children with incontinence.

Sleep duration, sleep problems and developmental trajectories of urinary incontinence: a prospective cohort study

“…Some of these studies did not exclude children with daytime wetting [5,6], and some used objective measures of sleep disturbances [5,8] which might explain the differences in ndings. In contrast to the study by von Gontard and colleagues [10], we found evidence that sleep problems (e.g., night-time waking, di culty going to sleep, getting up after being put to bed) were prospectively associated with incontinence, speci cally UI classes that were characterized by daytime wetting alone, or a combination of daytime and night-time wetting at school-age.…”

“…The study found that sleep problems were not more common in children with bedwetting and/or daytime wetting compared with continent children. Contrary to earlier research, a notable nding of the study is that children with enuresis had fewer night-time awakenings than their peers who had attained night-time bladder control [10].…”

“…To our knowledge, only one previous study examined associations between sleep problems and both enuresis and daytime UI but did not nd evidence for cross-sectional associations [10]. In agreement with this study, we did not nd evidence for associations between sleep problems and bedwetting alone.…”

“…Another explanation is that the observed associations between sleep problems and UI could be due to common causes such as neurodevelopmental disorders. Attention de cit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are associated with a high prevalence of sleep problems [35,36] and incontinence (especially daytime wetting) [10]. We adjusted our analysis for factors at preschool age that are associated with ADHD and ASD including developmental delay, di cult child temperament, and child emotional/behaviour problems, but many of the associations between sleep problems and incontinence persisted.…”

“…To our knowledge, the association between sleep problems and both bedwetting and daytime wetting has been examined in only one cross-sectional study (a community-based study of 638 children with mean age 5.9 years) [10]. The study found that sleep problems were not more common in children with bedwetting and/or daytime wetting compared with continent children.…”