738 COMORBIDITY BETWEEN NOCTURNAL ENURESIS, DISRUPTED SLEEPPATTERN AND INCREASED WATER AND SOLUTE EXCRETION OVERNIGHT

Abstract

You have accessJournal of UrologyPediatrics: Bladder Dysfunction - Myelodysplasia, Voiding Dysfunction, Enuresis1 Apr 2010738 COMORBIDITY BETWEEN NOCTURNAL ENURESIS, DISRUPTED SLEEPPATTERN AND INCREASED WATER AND SOLUTE EXCRETION OVERNIGHT Johan Vande Walle, Nele Hertegonne, Karlien Dhondt, Charlotte Van Herzeele, Ann Raes, Erik Van Laecke, Ann De Guchtenaere, and Piet Hoebeke Johan Vande WalleJohan Vande Walle More articles by this author , Nele HertegonneNele Hertegonne More articles by this author , Karlien DhondtKarlien Dhondt More articles by this author , Charlotte Van HerzeeleCharlotte Van Herzeele More articles by this author , Ann RaesAnn Raes More articles by this author , Erik Van LaeckeErik Van Laecke More articles by this author , Ann De GuchtenaereAnn De Guchtenaere More articles by this author , and Piet HoebekePiet Hoebeke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1264AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pathogenesis of nocturnal enuresis is classicaly attributed to three factors 1) nocturnal polyuria, 2) OAB 3) deep sleep and abnormal arousal. CK Yeung put the deep sleep theory in question at the last ICCS meeting, demonstrating rather superficial sleep in children with nocturnal enuresis. Mahler and the Aarhus group demonstrated that sleep deprivation induces diuresis and natriuresis. The aim of this study was to demonstrate that abnormal sleep pattern in children coincides with nocturnal polyuria and high osmotic and sodium-excretion during the night. METHODS A non invasive screening (ICCS standardisation), a sleep registration, a study of 24 h circadian rhythm of diuresis, sodium and osmotic excretion. A study-group of 37 patients with refractory enuresis and documented nocturnal polyuria. RESULTS 35/37 patients had a severely disrupted sleeppattern. The major characteristics were especially motor activity and movements during the night, compatible with restless legs syndrome (33/37) and difficulties to fall asleep (N=8). This was correlated with high nocturnal diuresis-rate (135 ± 13 % of expected bladder volume for age) (p<0.05), abnormal circadian rhythm of sodium and osmotic excretion overnight (p<0.05), and increased sodium excretion overnight compared with control population (118 ± 13%) (p<0.01). CONCLUSIONS The data show that sleeping pattern disorders are far more frequent in children with therapy resistant enuresis than so far accepted. Our data do not only confirm the recent findings from CK Yeung, but demonstrate a correlation with several circadian rhythms of renal function and/or absolute values of nocturnal excretion. If the finding is only a simple comorbidity, plays a role in therapy resistance or in primary pathogenesis remains to be elucidated. Gent, Belgium© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e289 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johan Vande Walle More articles by this author Nele Hertegonne More articles by this author Karlien Dhondt More articles by this author Charlotte Van Herzeele More articles by this author Ann Raes More articles by this author Erik Van Laecke More articles by this author Ann De Guchtenaere More articles by this author Piet Hoebeke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...