Effects of desmopressin on the sleep of children suffering from enuresis

Abstract

Aim: To evaluate the effect of 1-desamino-8-D-Arginine Vasopressin (DDAVP) on sleep architecture and arousal reactions in children with primary monosymptomatic nocturnal enuresis (PME). Methods: A prospective, placebo-controlled, randomized, double-blind, cross-over study was performed on children suffering from bed-wetting. Placebo and DDAVP were given for 7 days each after which an unattended home polysomnography (PSG) was recorded. After lifting the blinding, the PSGs were compared. Results: A total of 20 children with PME, aged 6-15 years, were enrolled in the study. The number of wet nights decreased significantly with DDAVP treatment. Delta power, distribution of sleep stages, number of arousals, arousal index and the effect of arousals on sleep stages did not differ significantly. Bed-wetting occurred within each sleep stage and did not follow any particular pattern. In most cases, it was preceded by an arousal reaction, but no awakening occurred.Conclusion: DDAVP has no effect on the sleep architecture of children with PME when analysed by classical PSG, which is determined by collecting the electric activity of cortical neurons. Taking recent research findings into account, this supports the thesis that the disturbances causing PME occur at brain stem level and do not reach consciousness.

Role of sleep in the regulation of the immune system and the pituitary hormones

“…Likewise, in elderly humans, the subchronic intranasal administration of AVP (for 30 days) increased slow wave sleep, 19 and the intravenous administration of AVP in young adult men decreased REM sleep 20 . In contrast, AVP administration for 1 week in children did not affect the sleep pattern 21 . Vasotocin, an oligopeptide hybrid between oxytocin and AVP, present in nonmammal vertebrates and fetal mammals, 22 increased the amount of REM sleep, decreased REM sleep latency, and induced REM sleep episodes at sleep onset when intranasally administered to healthy prepubertal boys; however, neither AVP nor oxytocin were able to induce those effects in the same participants 23 .…”

Case report: Desmopressin and somnambulism

“…However, a direct effect on the central nervous system (CNS) by desmopressin can not entirely be excluded [14,15]. The major mechanism of desmopressin in NE results in an increased urinary concentration and subsequent decreased diuresis-rate.…”

Avaliação comparativa da eficácia do uso isolado e combinado de alarme noturno e desmopressina no tratamento da enurese noturna monossintomática

“…literatura27,37,202 . Bader et al27 descreveram o sono de crianças enuréticas como normal, a exceção da presença de encurtamento do ciclo de sono e aumento significativo no número dos ciclos por noite.…”