Symptoms of sleep-disordered breathing in children with nocturnal enuresis

Abstract 

Objectives

There is an association between sleep-disordered breathing (SDB) and nocturia in adults, raising the question as to whether SDB could play a role in the aetiology of nocturnal enuresis (NE) in children. The aim of this study was to determine whether there is an association between these two conditions.

Methods

The study group comprised 40 patients, aged 5–15years, with enuresis and the control group 40 children undergoing routine day-case surgery. Subjects completed a Pediatric Sleep Questionnaire (PSQ) and a questionnaire assessing lower tract symptoms. Categorical variables were analysed using Pearson's Xi² test, and group differences for continuous variables using Mann–Whitney and Kruskal–Wallis tests or t-tests according to the distribution of data.

Results

The groups were well matched. Patients with NE had significantly higher total PSQ scores (P<0.001). PSQ subscales relating to daytime sleepiness (P<0.003) and daytime behaviour (P<0.000) were significantly worse in NE patients. The snoring subscale was not statistically different (P<0.051), but a comparison of females alone showed a highly significant difference (P<0.001) with higher snoring subscale scores in girls with NE.

Conclusion

Children with NE had significantly higher PSQ scores. The data suggest an association between NE and SDB in girls. The significantly higher level of reports of daytime sleepiness and behavioural problems in all NE children warrants further study to determine the potential causative pathways and clinical relevance of these findings. SDB could be usefully assessed in children with NE, particularly when they do not respond to standard treatment.

Keywords: Nocturnal enuresis, Sleep disordered breathing