70% of children suffering from bedwetting have sleep apnea

Egypt: Nocturnal enuresis (NE) or bedwetting is commonly associated with obstructive sleep apnea (OSA), especially in obese children, a recent study published in the Lung journal has found. According to the study, almost 70% of school-aged children (>5-16 years old) with NE have OSA. The common risk factors were nasal obstruction, abnormal facial phenotype, and high-arched palate.

Nocturnal enuresis is a widespread condition that affects approximately 5–10% of school-aged children and is a cause of significant psychological distress to affected children and their family members.

Hanaa Shafiek, Faculty of Medicine Alexandria University, Alexandria, Egypt, and colleagues aimed to detect obstructive sleep apnea among school-age children presented with nocturnal enuresis and to identify the possible risk factors for OSA in them.

The study enrolled 66 children aged > 5–16 years presented with NE. Children with urinary tract anatomical abnormalities or infection, intellectual disabilities, genetic syndromes, psychological issues, and diabetes mellitus were excluded. They were clinically examined, scored using sleep clinical record score (SCR), and subjected for full-night polysomnogram (PSG).

OSA was defined by obstructive apnea/hypopnea index (AHI) ≥2 episodes per hour. Obesity was defined as BMI ≥95th percentile.

Read Also: New guidelines for management of nocturnal enuresis in children

Key findings of the study include:

• Fifty-four children (81.8% of the recruited children) aged 8.3 ± 2.8 years agreed to undergo PSG as 68.5% had OSA with median obstructive AHI of 6.1 (3.7–13.2) episodes/h, median oxygen saturation of 97% and nadir of 88%.


• Thirty-three percent were obese with significantly higher AHI [7.0 (3.7–12.4) vs. 2.4 (1.3–6.1) episodes/h].


• SCR score correlated significantly with AHI (r² = 0.462) with 91% sensitivity in detecting OSA ≥ 5 episodes/h.


• Nasal obstruction, adenoid/adult facial phenotype, and arched palate were associated with OSA.

The findings emphasize that school-aged children with NE should undergo polysomnography and OSA treatment has the potential to reduce NE.

The study, "Obstructive Sleep Apnea in School-Aged Children Presented with Nocturnal Enuresis," is published in the journal Lung.

DOI: https://doi.org/10.1007/s00408-019-00304-6