Nocturnal Enuresis Significantly Prevalent in Children with Obstructive Sleep Apnea, reports study

Obstructive sleep apnea (OSA) is a breathing disorder characterized by repeated episodes of upper airway obstruction during sleep, disrupting normal patterns. It is a sleep disorder that peaks in children between 3-6 years of age. The breathing issues at night can also affect dental occlusion and craniofacial development. Adenotonsillectomy (AT) is the primary treatment for pediatric OSA. Nocturnal enuresis (NE) is intermittent incontinence during sleep, and its prevalence decreases with age. Literature shows that NE has a high prevalence in OSA and reduces when OSA is treated with AT. However, there is limited data on the prevalence of NE in OSA children compared to their healthy peers. Researchers conducted a study to determine the prevalence of NE in children with apnea OSA, the effect of AT, and the width of the arches and to compare them with control children without respiratory problems.

The study included 298 children within the age range of 2 to 12 years old. There were two age groups of children aged 2–<5 years and ≥5–12 years. Participants were divided into two main groups: an experimental group (n = 130) and a control group (n = 168). The experimental group was further divided into two subgroups: children with OSA and NE (n = 51) and children with OSA but without NE (n = 79). Children having at least one bedwetting incident per month were identified as having NE. Arch widths were measured at the baseline and one year after. Polysomnography was used to diagnose OSA, and the apnea-hypopnea index (AHI) was obtained. A Pediatric Sleep Questionnaire (PSQ) was given to the parents to classify their children into those with and without NE.

Findings:

• This study included 130 subjects in the OSA group, while the control group consisted of 168 subjects.
• There were no sexual differences in the occurrence of OSA
• About 39.2% of patients in the OSA group experienced NE compared to 28% in the control group, which had a significant prevalence.
• About 49% of the patients with both OSA and NE experienced a complete resolution of NE after surgery.
• Both OSA groups had narrower arch widths than the control group (p = 0.012), with the NE group having the narrowest widths.
• After the assessments before and after the surgery, children with OSA had a statistically significant prevalence of NE compared to the control group.
• Patients with OSA, with and without NE, showed very similar AHI results, though those with NE had slightly higher AHI values.
• Children with OSA exhibited narrower intercanine and intermolar widths in the upper and lower arches compared to the control group.

Thus, the study concluded that nocturnal enuresis is more prevalent in children with OSA and should be considered and evaluated as one of the first signs of breathing disorders. These findings underscore the importance of recognizing nocturnal enuresis as one of the potential clinical markers for OSA in pediatric patients.

Further reading: The Relationship between Nocturnal Enuresis and Obstructive Sleep Apnea in Children. Doi: https://doi.org/10.3390/children11091148