Relationship between nocturnal enuresis and sleep in children and adolescents

Fernandes, Ana Elisa Ribeiro; Roveda, José Reinaldo Corrêa; Fernandes, Carolina Rodrigues; Silva, Diego Ferreira; Guimarães, Isabela Cristina de Oliveira; Lima, Eleonora Moreira; Mrad, Flávia Cristina de Carvalho; Vasconcelos, Mônica Maria de Almeida

doi:10.1007/s00467-022-05818-5

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…Previous research has reported that breathing disorders are more common among children with enuresis [4]. It has been suggested that sleep disturbance due to breathing problems could increase arousal thresholds, which could cause children to fail to respond to signs that they need to urinate [5].…”

Section: Potential Mechanisms Explaining the Ndingsmentioning

confidence: 99%

“…Whilst most previous studies focused on sleep and enuresis [3,4], a strength of our study is the inclusion of daytime wetting, which has been a neglected topic in existing research. A limitation is that the 'bedwetting alone' class did not exclude children with other lower urinary tract symptoms such as urgency and frequency irrespective of daytime wetting.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Acquisition of bladder control is a key developmental milestone that has been examined in relation to sleep. Most of the existing research focuses on bedwetting (enuresis) and comprises case-control studies of small samples [3,4]. This previous work implicates sleep problems in the pathophysiology of the bedwetting.…”

Section: Introductionmentioning

confidence: 99%

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

Joinson

Grzeda

Heron

et al. 2023

Preprint

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Objective To examine if sleep duration and sleep problems are associated with urinary incontinence (UI) in children. Methods We used multinomial logistic regression to examine the association of child sleep duration/problems at 3½ years with developmental trajectories of bedwetting and daytime wetting from 4–9 years in 8,751 (4,507 boys and 4,244 girls) from the Avon Longitudinal Study of Parents and Children. We adjusted for sex, socioeconomic indicators, mothers’ emotional/practical/financial support, developmental delay, stressful life events, temperament, and emotional/behaviour problems. Results Preschool children who slept more than 8½ hours per night had a decreased probability of UI at school-age. There was a 33% reduction in odds of daytime wetting per additional hour of sleep (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.52–0.86). Sleep problems were associated with increased odds of daytime wetting (e.g., getting up after being put to bed: OR = 2.20, 95% CI = 1.43–3.39), delayed bladder control (e.g., breathing problems whilst sleeping: OR = 1.68, 95% CI = 1.12–2.52), and persistent (day and night) wetting (e.g., night-time waking: OR = 1.53, 95% CI = 1.16-2.00). Waking during the night and waking up early in the morning were associated with reduced odds of bedwetting at school-age (OR = 0.76, 95% CI = 0.61–0.96 and OR = 0.80, 95% CI = 0.64–0.99 respectively). Conclusions Preschool children who sleep for longer have a lower likelihood of UI at school-age, whilst those with sleep problems are more likely to experience daytime wetting and combined (day and night) wetting, but not bedwetting alone. Short sleep duration and sleep problems in early childhood could be indicators of future problems attaining and maintaining bladder control.

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Section: Potential Mechanisms Explaining the Ndingsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

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

Joinson

Grzeda

Heron

et al. 2023

Preprint

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“…Children with nocturnal enuresis are known to have difficulty in perceiving and waking up to micturition during sleep, 4 and recent studies using sleep meters have shown that this is not due to deep sleep but rather to poor sleep quality. 5,6 The second etiology is the bladder's inability to hold urine during sleep. A urodynamic study of patients with monosymptomatic nocturnal enuresis reported normal urodynamics during the day; however, the frequency of bladder contractions is increased when urinary incontinence is present during sleep.…”

Section: Introductionmentioning

confidence: 99%

“…The first is difficulty in awakening. Children with nocturnal enuresis are known to have difficulty in perceiving and waking up to micturition during sleep, 4 and recent studies using sleep meters have shown that this is not due to deep sleep but rather to poor sleep quality 5,6 . The second etiology is the bladder's inability to hold urine during sleep.…”

Section: Introductionmentioning

confidence: 99%

Management of treatment‐resistant nocturnal enuresis

Tsuji

Kaneko

2023

Pediatrics International

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Nocturnal enuresis is defined as intermittent urinary incontinence during sleep in children 5 years of age and older, occurring at least once a month for at least 3 months. In Japan, pediatricians who do not specialize in nocturnal enuresis have become more proactive in treating the condition since 2016, when the guidelines for treating it were revised for the first time in 12 years. For monosymptomatic nocturnal enuresis, the first step is lifestyle guidance, with a focus on the restriction of fluid intake at night; however, if lifestyle guidance does not decrease the frequency of nocturnal enuresis, aggressive treatment should be added. The first choice of aggressive treatment is oral desmopressin, an antidiuretic hormone preparation, or alarm therapy. However, there remain patients whose wet nights do not decrease with oral desmopressin or alarm therapy. In such cases, it is necessary to reconfirm the method of desmopressin administration and check for factors that may decrease the efficacy of desmopressin. If alarm therapy does not increase the number of dry nights, it is possible that the patient is fundamentally unsuitable for alarm therapy. If dry nights do not increase with oral desmopressin or alarm therapy, the next treatment strategy should be considered immediately to keep the patient motivated for treatment.

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

Joinson,

Grzeda,

Heron

et al. 2024

Eur Child Adolesc Psychiatry

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To examine if preschool sleep duration and sleep problems are associated with urinary incontinence (UI) at primary school-age. We used multinomial logistic regression to examine the association of child sleep duration/problems (3½ years) with UI trajectories (4–9 years) in 8751 (4507 boys, 4244 girls) from the Avon Longitudinal Study of Parents and Children. We adjusted for sex, socioeconomic indicators, mothers’ emotional/practical/financial support, developmental delay, stressful life events, temperament, and emotional/behaviour problems. Preschool children who slept more than 8½ hours per night had a decreased probability of UI at school-age. There was a 33% reduction in odds of daytime wetting per additional hour of sleep (odds ratio [OR] = 0.67, 95% confidence interval [CI] 0.52–0.86). Sleep problems were associated with increased odds of UI e.g., getting up after being put to bed was associated with daytime wetting (OR = 2.20, 95% CI 1.43–3.39); breathing problems whilst sleeping were associated with delayed bladder control (OR = 1.68, 95% CI 1.12–2.52), and night-time waking was associated with persistent (day and night) wetting (OR = 1.53, 95% CI 1.16–2.00). Waking during the night and waking up early in the morning were associated with reduced odds of bedwetting at school-age (OR = 0.76, 95% CI 0.61–0.96 and OR = 0.80, 95% CI 0.64–0.99 respectively). Preschool children who sleep for longer have a lower likelihood of UI at school-age, whilst those with sleep problems are more likely to experience daytime wetting and combined (day and night) wetting, but not bedwetting alone. Short sleep duration and sleep problems in early childhood could be indicators of future problems attaining and maintaining bladder control.

show abstract

Relationship between nocturnal enuresis and sleep in children and adolescents

Cited by 5 publications

References 37 publications

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

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

Management of treatment‐resistant nocturnal enuresis

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

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