Sleep Pattern in Primary Enuretic Children

Objectives: Nocturnal enuresis is a common problem in children. A disturbance of sleep was suggested as a pathogenetic factor. Our aim is to compare sleep of primary nocturnal enuretic children with a group of matched controls.

Subjects and methods: This study was carried out on two groups; Patient group: included 20 patients; 13 males and 7 females with primary monosymptomatic nocturnal enuretic. Age range between 6-15 years and control group: included 20 apparently healthy subjects (10 males and 10 females) without any urological, neurological or other medical diseases. Nocturnal enuresis sheet, sleep questionnaire, Intelligence quotient and overnight polysomnography were applied.

Results: Nocturnal enuresis was common in males than females in patient group with no significant difference. Family history of NE was positive in 65% of cases. Excessive somnolence was significantly higher in patients than in control group. Arousal disorders and sleep wake transition disorders were common in patient group than control group with no significant difference between the two groups. There was a significant increase in stage 3 and 4 duration and a highly significant decrease in arousal index in patients in comparison to the control group. There was no statistically significant difference in sleep latency, REM latency and stage 1 & 2 duration in patients in comparison to control group. Enuretic events were distributed across the night and not related to specific sleep stage.

Conclusions: It seems that some children with primary nocturnal enuresis are deep sleepers. A high arousal threshold may be one of the pathogenetic factors underlying primary nocturnal enuresis.