Zhang Q, Zhu W, Wang C, Shan S, Zhang G, Wen J, Wang Q. Nocturnal Bladder Function and Sleep in the Children with Refractory Nocturnal Enuresis: A Prospective Study.
Urology 2023;
182:218-224. [PMID:
37696309 DOI:
10.1016/j.urology.2023.08.032]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/20/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE
To prospectively investigate the nocturnal bladder function and sleep in children with refractory primary monosymptomatic nocturnal enuresis (RPMNE).
MATERIALS AND METHODS
Fifty-three children diagnosed with RPMNE and 30 controls who had upper urinary tract abnormality but without any voiding problems were included in the study. RPMNE patients underwent a standardized investigation protocol, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, a 7-day bladder diary, and the simultaneous ambulatory urodynamic monitoring and polysomnography (PSG); controls were evaluated using the PSQI questionnaire and PSG.
RESULTS
The children with RPMNE were subdivided into the nocturnal detrusor overactivity (NDO) case group and the non-NDO case group. The children in the NDO case group had a higher percentage of total sleep time in light sleep and a lower percentage in the N3 sleep stage than those in the non-NDO case group and control group (P <.05). The cortical arousal index and PSQI scores of both RPMNE subgroups were higher compared to the control group (P <.05). The incidences of reduced nocturnal bladder capacity (NBC) in the NDO case group were higher than in the non-NDO case group (P <.05). The frequency of involuntary detrusor contractions during sleep was positively correlated with cortical arousal index in the NDO case group (r = 0.811, P <.0001).
CONCLUSION
In addition to the reduced NBC, the RPMNE is related to abnormal NDO, increased light sleep period, and cortical arousal dysfunction. Moreover, there is a certain correlation between the abnormal degrees of NDO and cortical arousal dysfunction.
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