Enuresis is a considerable medical and socio-psychological problem. The pathophysiology of enuresis remains unknown; none of the existing theories can explain its nature in full. The article reviews the studies devoted to the role of obstructive sleep disturbances in the occurrence of enuresis. The mentioned sleep disturbances in children are associated with other related disorders: pulmonary hypertension, developmental delay, sleepwalking, attention deficit and hyperactivity disorder, obstructive sleep apnea syndrome and enuresis. Numerous studies confirm the correlation of the mentioned syndromes. The obstruction of the upper respiratory tract during sleep is accompanied by an increase in the efforts of the respiratory muscles and negative intrathoracic pressure, which is associated with high atrial natriuretic peptide and low antidiuretic hormone levels. In most cases the surgical removal of respiratory tract obstruction (adenotonsillectomy) leads to significant improvement or complete resolution of enuresis. This category of patients requires a comprehensive interdisciplinary approach to the examination and treatment by the pediatricians, psycho-neurologists and ENT specialists.
Sleep-related breathing disorders in children are usually caused by adenotonsillar hypertrophy and associated with many related disorders: pulmonary hypertension, developmental delay, sleepwalking, attention deficit hyperactivity disorder, obstructive sleep apnea, and enuresis. Numerous studies indicate the correlation of the above syndromes. Surgical removal of airway obstruction (adenotonsil lectomy) in most cases leads to complete resolution or significant improvement of comorbid disorders. A comprehensive interdisciplinary approach to the examination of this category of patients and their treatment with the participation of pediatricians, psycho-neurologists, and ENT specialists is required.
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