Nocturnal enuresis in children with upper airway obstruction

doi:10.1016/S0165-5876(85)80018-5

International Journal of Pediatric Otorhinolaryngology

Volume 9, Issue 2, July 1985, Pages 173-182

https://doi.org/10.1016/S0165-5876(85)80018-5 Get rights and content

Summary

This article reviews 35 children between the ages of 3½ and 11 years who have had symptoms of upper airway obstruction and enuresis. Twenty-eight patients had primary enuresis, and 7 had secondary enuresis. Removal of upper airway obstruction by surgical intervention led to a significant decrease or complete cure of nocturnal enuresis in 26 patients. Four children were studied with polysomnographic tracings in relationship to their enuresis.

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Sleep apnea, hypersomnolence, and upper airway obstruction secondary to adenotonsillar enlargement
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There are more references available in the full text version of this article.

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Considerando que un adulto con síndrome de apnea-hipopnea obstructiva del sueño generalmente se presenta con una historia de obesidad, ronquidos y somnolencia diurna importante, un niño con el mismo problema es más probable que se presente con el peso normal, hipertrofia adenoamigdalar y falta de atención durante las clases de la escuela. Podemos dividir los síntomas del cuadro infantil en los propios del trastorno respiratorio del sueño como los ronquidos, los síntomas de la calidad del sueño como la enuresis, y los síntomas de los trastornos de la conducta y del aprendizaje como la hiperactividad.
Adults with obstructive sleep apnea-hypopnea syndrome typically have a history of obesity, snoring, and prominent daytime somnolence. However, children with this condition are more likely to have normal body weight, adenoid and tonsillar hypertrophy, and inattentiveness during school classes. The symptoms of children with sleep apnea-hypopnea syndrome can be divided into those of sleep-disordered breathing —such as snoring—, symptoms of sleep quality —such as enuresis—, and symptoms of behavior or learning disorders —such as hyperactivity—.
Re: Resolution of Diurnal Incontinence and Nocturnal Enuresis After Adenotonsillectomy in Children. F. Firoozi, R. Batniji, A. R. Aslan, P. A. Longhurst and B. A. Kogan J Urol 2006; 175: 1885-1888
2008, Journal of Urology
Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey
2008, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
Habitual snoring was a significant problem for children and might be associated with diurnal symptoms, as reported by Ersu et al. [19]. Weider et al.described enuresis that is to both chronic adenotonsillar hypertrophy and significant airway obstruction that was relieved by adenotonsillectomy [20–21]. A proposed cause of enuresis is poor nocturnal regulation of antidiuretic hormone release and increased atrial natriuretic peptide, which is related to rapid eye movement (REM) sleep disorders.
The purpose of this study is to investigate the prevalence of an existing relationship between adenoid hypertrophy and nocturnal enuresis in primary school children.
The study was performed in four primary schools that were chosen randomly in Kartal, Istanbul. The children's parents were asked to fill out a questionnaire that included questions concerning the associated symptoms of adenoid hypertrophy and nocturnal enuresis. The interrelations between adenoid hypertrophy and nocturnal enuresis items were examined by X2 tests.
The study population consisted of 1132 (625 girls, 621 boys) primary school children between 5 and 14 years of age (mean 9.59 ± 2.60 years). The children were divided into three groups with 5–7 years old children in Group I (n = 232), 8–10 years old children in Group II (n = 506) and 11–14 years old children in Group III (n = 394). Of the 1132 distributed questionnaires, 1090 (87.4%) were filled in adequately and were accepted for evaluation. Prevalence of adenoid hypertrophy in school children was found to be 58 in Group I (27%), 94 in Group II (19.5%) and 78 in Group III (19.9%). Prevalence of nocturnal enuresis in school children was found to be 35 in Group I (15.1%), 51 in Group II (10.1%) and 18 in Group III (4.6%). No statistically significant association was present between adenoid hypertrophy and nocturnal enuresis in either Group I, II or III school children.
In contrast to previous studies, our prevalence study did not find an association between adenoid hypertrophy and nocturnal enuresis. Thus, this prevalence study provides otolaryngologists new and interesting information.
Resolution of Diurnal Incontinence and Nocturnal Enuresis After Adenotonsillectomy in Children
2006, Journal of Urology
Adenotonsillar hyperplasia causes upper airway obstruction, leading to obstructive sleep apnea. We reviewed the incidence of nocturnal enuresis in a population of children with adenotonsillar hyperplasia. In addition, we investigated the rate of resolution or improvement in enuresis following surgery for relief of adenotonsillar hyperplasia.
We studied 86 consecutive prepubertal children, 46 boys and 40 girls, who underwent adenotonsillectomy. Severity of adenotonsillar obstruction was graded on a scale of 1 to 4. A questionnaire regarding voiding problems, including nocturnal enuresis, voids per day and daytime enuresis episodes, was filled out preoperatively and postoperatively by the patients and their parents.
Among the 86 patients who underwent adenotonsillectomy 36 (42%) had nocturnal enuresis. In patients with nocturnal enuresis the number of episodes was significantly less after adenotonsillectomy. Overall, 12 patients (33%) had complete resolution, 11 (31%) had significant improvement and 13 (36%) showed no change. In addition, we noted a significant decrease in daytime enuresis episodes and voids per day.
Children with upper airway obstruction have a high rate of nocturnal enuresis that improves at twice the anticipated rate after treatment of the airway obstruction. In addition, we observed that daytime voiding dysfunction improves in these patients.

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PaperNocturnal enuresis in children with upper airway obstruction

Summary

Enuresis: an attempt at classification by genesis

Acta. paediat. scand.

Sleep Apnea: A Non-Technical Presentation

Enuresis—Is it being ovetreated?

UPPP for sleep apnea and snoring

Ear Nose Throat J.

Sleep apnea syndromes and related disorders

Sleep apnea, hypersomnolence, and upper airway obstruction secondary to adenotonsillar enlargement

Arch. Otolaryng.

Paper
Nocturnal enuresis in children with upper airway obstruction