Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul 4;8(3):521-7.
doi: 10.5114/aoms.2012.28809.

Association between primary nocturnal enuresis and habitual snoring in children with obstructive sleep apnoea-hypopnoea syndrome

Afroditi V Sakellaropoulou  1 , Maria N Hatzistilianou, Maria N Emporiadou, Victor T Aivazis, John Goudakos, Konstantinos Markou, Fanni Athanasiadou-Piperopoulou
Affiliations

Association between primary nocturnal enuresis and habitual snoring in children with obstructive sleep apnoea-hypopnoea syndrome

Afroditi V Sakellaropoulou et al. Arch Med Sci. .

Abstract

Introduction: Nocturnal enuresis (NE) and obstructive sleep apnoea-hypopnoea syndrome (OSAHS) are common problems during childhood, and population studies have reported a significant correlation between them. This study aimed to assess whether habitual snoring, mouth breathing and daytime sleepiness are associated with increased incidence of NE in children with OSAHS.

Material and methods: Polysomnography was performed in 42 children (66.7% males), 3.5-14.5 years old, who were evaluated for sleep-disordered breathing (SDB).

Results: Fourteen out of 42 children (33.3%) presented mild, 16 out of 42 (38.1%) moderate and 12 out of 42 (28.6%) severe degree of OSAHS. Apnea hypopnea index (AHI) ranged between 1.30-94.20 (10.54 ±15.67) events per hour of sleep. Nocturnal enuresis was reported in 7/42 (16.7%) of them. The main observed symptoms were snoring (90.5%), restless sleep (81%), mouth breathing (71.4%), nasal congestion (76.2%), and difficulty in arousal (52.4%). A statistically significant association was found between NE and mouth breathing (p = 0.014) or nasal congestion (p = 0.005). Children with OSAHS and NE had a higher arousal index (8.14 ±8.05) compared with OSAHS children without NE (4.61 ±7.95) (p = 0.19, z = -1.28). Snorers had higher levels of AHI (11.02 ±16.37) compared with non-snorers (6.05 ±4.81) (p = 0.33, z = -0.96), and habitually snorers (23/42, 54.76%) were at greater risk of having NE (4/23) than were non-snorers (0/4, p = 0.36). However, the prevalence of enuresis was not related to the severity of OSAHS, expressed as AHI (p = 0.70).

Conclusions: Mouth breathing, nasal congestion and high threshold of arousal during sleep should be more carefully evaluated in cases of children with NE who do not respond to standard treatment and present SDB.

Keywords: nocturnal enuresis; sleep apnoea syndrome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age distribution based on the presence or not of nocturnal enuresis
Figure 2
Figure 2
Correlation between the presence of nocturnal enuresis and arousal index per hour of sleep
See this image and copyright information in PMC

References

    1. Stone J, Malone PS, Atwill D, McGrigor V, Hill CM. Symptoms of sleep-disordered breathing in children with nocturnal enuresis. J Pediatr Urol. 2008;4:197–202. - PubMed
    1. Firoozi F, Batniji R, Aslan AR, Longhurst PA, Kogan BA. Resolution of diurnal incontinence and nocturnal enuresis after adenotonsillectomy in children. J Urol. 2006;175:1885–8. - PubMed
    1. Alexopoulos EI, Kostadima E, Pagonari I, Zintzaras E, Gourgoulianis K, Kaditis AG. Association between primary nocturnal enuresis and habitual snoring in children. Urology. 2006;68:406–9. - PubMed
    1. Butler RJ, Golding J, Heron J. ALSPAC Study Team. Nocturnal enuresis: a survey of parental coping strategies at 7 1/2 years. Child Care Health Dev. 2005;31:659–67. - PubMed
    1. Caldwell PH, Edgar D, Hodson E, Craig JC. 4. Bedwetting and toileting problems in children. Med J Aust. 2005;182:190–5. - PubMed