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Sleep disordered breathing in enuretic children and controls
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Publ Dent Hlth Serv, Dept Orthodont, Vretgrand 9A, SE-75322 Uppsala, Region Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
Postgrad Dent Educ Ctr, Dept Orthodont, Orebro, Region Orebro C, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
2017 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 13, no 6, p. 620.e1-620.e6Article in journal (Refereed) Published
Abstract [en]

Introduction: Nocturnal enuresis and sleep disordered breathing are common childhood problems that are reported to be associated with each other. Sleep disordered breathing is often found in children with upper airway obstruction and, according to some studies, its presence is associated with an increased risk of nocturnal enuresis. Respiration during sleep in children with therapy-resistant enuresis, but no history of snoring or sleep apneas, has previously been investigated, and subclinical signs of disordered respiration were found in this group. However, sleep disordered breathing in enuretic children without a history of snoring or sleep apneas has not been thoroughly studied before.

Aim: To evaluate sleep disordered breathing in enuretic children and compare them with healthy control children.

Subjects and methods: Children aged 8-13 years with nocturnal enuresis were included. Exclusion criteria were: daytime incontinence, on-going anti-enuretic treatment, and concomitant urological, endocrinological, nephrological or psychiatric disorders. Twenty children (19 boys and 1 girl) suffering from therapy-resistant nocturnal enuresis, and 21 healthy controls (18 boys and 3 girls) underwent one night of polygraphic sleep registration focused on respiratory variables. The registration included electroencephalography as well as assessment of respiratory movements, nasal airflow and oxygen saturation; it was performed with a portable sleep device at the subjects' homes. In addition to this, OSA 18, a health-related quality of life instrument, was used to evaluate subjective issues related to sleep and breathing.

Results: The mean apnea hypopnea index values were 0.96 +/- 0.8 for the patient group and 0.46 +/- 0.4 for the control group. The oxygen desaturation index was slightly higher for the children with nocturnal enuresis compared with the healthy controls (P = 0.05). No other differences were found in the respiratory variables. Both groups of children showed low levels of arousals (Summary Table). The enuretic children reported significantly more subjective sleep disturbances and a lower quality of life than their healthy peers.

Discussion: This was the first controlled study of sleep disordered breathing in children with nocturnal enuresis. One limitation of the study was that some variables were known to be underestimated when scoring polygraphic data. The apnea hypopnea index was such a variable and was indeed lower than in a previous study.

Conclusion: No major differences in respiration during sleep were found between enuretic children and controls.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2017. Vol. 13, no 6, p. 620.e1-620.e6
Keywords [en]
Nocturnal enuresis, Sleep disordered breathing, Respiratory polygraphy, Children
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-340287DOI: 10.1016/j.jpurol.2017.05.012ISI: 000418045800024OAI: oai:DiVA.org:uu-340287DiVA, id: diva2:1178241
Available from: 2018-01-29 Created: 2018-01-29 Last updated: 2018-01-29Bibliographically approved

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Ring, Ingrid JönsonMarkström, AgnetaNevéus, Tryggve

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