Desmopressin use in pediatric nocturnal enuresis patients: is there a sex difference in prescription patterns?

Schroeder, Marie K.; Juul, Kristian Vinter; Mahler, Birgitte; Nørgaard, Jens Peter; Rittig, Søren

doi:10.1007/s00431-017-3074-x

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…Unrefreshing sleep, enuresis, and snoring frequency are associated in boys, but not in girls after stratification according to grade. There are many developmentally‐regulated factors that appear to modulate the association of SDB and enuresis between boys and/or girls: first, renal sensitivity to vasopressin seems to differ between boys and girls, and could have an effect on urinary volume. Second, sex hormonal effects may have a beneficial effect on the prevalence of SDB in girls, as seen in pre‐menopausal adult women .…”

Section: Discussionmentioning

confidence: 99%

Nocturnal enuresis and sleep disordered breathing in primary school children: Potential implications

Wada

Kimura

Tajima

et al. 2018

Pediatric Pulmonology

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The pathogenic mechanisms linking snoring and unrefreshing sleep to increased risk of NE are unknown. However, snoring, a surrogate reporter of SDB, is associated with increased urine production, while unrefreshing sleep may result from disrupted sleep facilitating increased sleep pressure and elevated arousal thresholds. Thus, both SDB and unrefreshing sleep are potential independent risk factors of NE in school age children.

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Section: Discussionmentioning

confidence: 99%

Nocturnal enuresis and sleep disordered breathing in primary school children: Potential implications

Wada

Kimura

Tajima

et al. 2018

Pediatric Pulmonology

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“…However, further research is required to completely understand the sex diferences in antidiuretic response of desmopressin. Schroeder et al [111] determined if there were sex-related diferences in renal sensitivity to desmopressin in Danish children with nocturnal enuresis (mean age 9.2 years). In this study, a greater percentage of girls than boys had a longterm efect of the lowest desmopressin lyophilizate dose, conirming the theory that girls could possibly be more sensitive to desmopressin than boys.…”

Section: Predictors Of Responsementioning

confidence: 99%

Pediatric Pharmacology of Desmopressin in Children with Enuresis: A Comprehensive Review

et al. 2020

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“…7 Several factors have been proposed to account for these differences, including varying renal sensitivity to vasopressin and sex hormone effects. 20,21 Kovacevic et al 13 reported that children with OSA who had higher arousal index and obstructive AHI on baseline PSG were more likely to experience NE resolution following AT than those with lower index scores. In their study, sex, race and ethnicity, body mass index, history of constipation, and preoperative number of wet nights weekly did not estimate the probability of NE outcomes.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea

Snow

Vazifedan

Baldassari

2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEChildren with obstructive sleep apnea (OSA) are at increased risk for nocturnal enuresis (NE). However, randomized clinical trials assessing NE outcomes in children randomized to adenotonsillectomy (AT) vs watchful waiting are lacking.OBJECTIVE To assess the outcomes of AT vs watchful waiting in children with nonsevere OSA who experience NE.DESIGN, SETTING, AND PARTICIPANTS Secondary analysis of data from a multicenter randomized clinical trial conducted at tertiary children's hospitals was performed. Participants included 453 children aged 5.0 to 9.9 years with nonsevere OSA who were randomized to either watchful waiting or AT as part of the multicenter Childhood Adenotonsillectomy Trial. Caregivers completed the Pediatric Sleep Questionnaire, which includes a binary item on bed-wetting, at baseline and 7-month follow-up. The trial was conducted between October 2007 and June 2012. Evaluation in this secondary analysis involving NE occurred from October 2019 to March 2021. INTERVENTIONS Adenotonsillectomy vs watchful waiting in children with NE.MAIN OUTCOMES AND MEASURES Prevalence of NE as defined by parental response to the Pediatric Sleep Questionnaire bed-wetting item at baseline and 7-month follow-up. RESULTSOf the 453 children enrolled, 393 were included in analysis; of these, 201 were girls (51.1%). Mean (SD) age at baseline was 6.54 (1.40) years. At baseline, the number of children with NE was similar (2.6%; 95% CI, −0.12% to 0.07%) between the AT (59 [30.7%]) and watchful-waiting (67 [33.3%]) groups. The odds of NE in the watchful-waiting group were approximately 2 times higher than the AT group after 7 months (odds ratio, 2.0; 95% CI, 1.3 to 3.1). Following AT, there was a decrease (−11.0%; 95% CI, −16.3% to −5.7%) in the number of children with NE (n = 38). The prevalence of NE did not change significantly (−0.5%; 95% CI, −5.4% to 6.4%) in the watchful-waiting group (n = 66) at follow-up. Although NE was less frequent in girls (adjusted odds ratio, 0.53; 95% CI, 0.33-0.85), other clinical factors, such as age, race and ethnicity, obesity, and apnea-hypopnea index, were not associated with improvement of NE. CONCLUSIONS AND RELEVANCEIn this secondary analysis of a randomized clinical trial, AT for the treatment of pediatric OSA appears to result in improvement in NE. Further research is needed to assess whether AT is associated with long-term benefits for NE compared with watchful waiting.

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Desmopressin use in pediatric nocturnal enuresis patients: is there a sex difference in prescription patterns?

Cited by 11 publications

References 19 publications

Nocturnal enuresis and sleep disordered breathing in primary school children: Potential implications

Nocturnal enuresis and sleep disordered breathing in primary school children: Potential implications

Pediatric Pharmacology of Desmopressin in Children with Enuresis: A Comprehensive Review

Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea

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