Elevated sleep arousal thresholds in enuretic boys: clinical implications

Abstract

Enuretic children are described as difficult to arouse from sleep. We studied auditory sleep arousal thresholds in enuretic boys and report on the clinical implications of these findings. Fifteen enuretic and 18 control subjects (7-12-year-old males) were studied in a sleep laboratory for four consecutive nights using standard polysomnographic recording techniques. Sleep was undisturbed for the initial two nights and waking thresholds were measured on the following two nights. Enuretic children wet most frequently in the first two-thirds of the night. Arousal attempts were successful 39.7% of the time in controls and only 9.3% of the time in enuretics. In conclusion, enuretic males were more difficult to arouse than age-matched controls. The elevated arousal thresholds may be due to delayed maturation. Treatment programmes that rely on awakening should be aware of these features.

Treatment of primary monosymptomatic nocturnal enuresis with desmopressin: predictive factors

“…Parents often report their enuretic child to be a deep sleeper, as shown in this study and others [19], and enuretic boys are reportedly more dif®cult to arouse than those who are not enuretic, especially during the ®rst two-thirds of the night [11]. With a small bladder capacity the wetting probably occurs early in the night and the arousal dif®culties will then be more important for the outcome.…”

“…A response to desmopressin was associated with a positive family history of nocturnal enuresis in one study [8], but not in another [9]. That children who are not enuretic do not always sleep through the night but wake up to void [10] suggests that abnormal arousal patterns are also associated with nocturnal enuresis [11].…”

Enuresis: Is bedwetting really isolated or not?

“…PNE is thought to be caused by reduced nocturnal bladder capacity, nocturnal polyuria, awakening problem or a combination of these factors (Hunsballe et al, 1995;Loening-Baucke, 1997;Wolfish et al, 1997;Lackgren et al, 1999;Kawauchi et al, 2002). Also genetic susceptibility, constipation and hypercalciuria have been attributed to the etiology of PNE whereas psychosocial factors, urinary tract infections, constipation, diabetes, neurogenic bladder are reported as causes of SNE (Pace et al, 1999;Robson and Leung, 2000;Sureshkumar et al, 2000;Raes et al, 2006).…”

Enuresis in pediatric practice

“…Это наблюдение может быть ошибочным, поскольку детей, не страдающих энурезом, родители будят редко. Тем не менее исследование в лаборатории сна показало, что порог пробуждения у здоровых детей ниже, нежели у детей, страдающих ноч-ным недержанием мочи (40 и 9% соответственно) [64]. Чрезмерно глубокий сон способствует ночному недер-жанию мочи у подростков и взрослых [65].…”