The association between sleep-disordered breathing and enuresis in children

Objectives/hypothesis: To evaluate the prevalence of nocturnal enuresis in children diagnosed with sleep disordered breathing (SDB) and the effect of adenotonsillectomy (T&A) on nocturnal enuresis.

Study design: Systematic review of the literature.

Methods: Systematic review of the literature was performed using PubMed and Ovid. A systematic analysis of the literature was performed from 1980 to 2010 to identify children who had SDB and enuresis. A subset of children with enuresis who underwent T&A for SDB were also studied.

Results: A total of 14 studies were reviewed. A total of 3,550 children had SDB, of which one-third (n = 1,113) had a diagnosis of enuresis. Age range was 18 months to 19 years. Seven studies (n =1,360) had data on patients who underwent T&A for SDB with follow-up data on enuresis. The mean sample size was 194, with a median follow-up of 6 months and age range of 2 to 18 years. Preoperative prevalence of enuresis was 31% (426/1,360). A total of 587 children were followed after T&A. The postoperative prevalence of enuresis was 16% (95/587; P < .0002, two-tailed). Most studies did not make a distinction between primary and secondary enuresis. The age range of the subjects (18 months to 19 years) likely included some patients with developmentally acceptable enuresis.

Conclusions: SDB in children is associated with nocturnal enuresis. T&A is associated with a significant improvement in enuresis in children with SDB. There is a need for randomized controlled trials to look at the role of T&A in children with SDB and enuresis.