Future Considerations in Nocturia and Nocturnal Polyuria
Nocturnal polyuria (NP), the most common etiology of nocturia, can be caused by various medical conditions, including cardiovascular disease, obstructive sleep apnea, renal tubular dysfunction, as well as medications (e.g. diuretics) and/or behavioral patterns. NP in the absence of underlying medical conditions has been described as nocturnal polyuria syndrome (NPS) and is thought be the result of impaired circadian release of endogenous arginine vasopressin (AVP). Desmopressin, a synthetic AVP analog, has been shown to be an effective replacement therapy in adults with nocturia due to NP.
Health related quality of life (HRQOL) is a relatively new concept in pediatrics, but it has shown to be extremely important in terms of clinical care, treatment planning, and compliance with medical and behavioral recommendations. Two groups of children who are at risk for impairments in HRQOL are those who have bedwetting and those who snore or have sleep apnea. However, the current study sought to determine whether the combination of monosymptomatic nocturnal enuresis (MNE) and sleep disordered breathing (SDB) results in diminished HRQOL in a pediatric sample.
CONCLUSIONS: Cardiopulmonary and renal reflex-induced neuroendocrine disorder may play an important role in the mechanism of NE in children with OSA, but this remains to be confirmed by animal studies. Other causes such as oxidative stress and inflammatory responses need to be further researched. PMID: 30446975 [PubMed - as supplied by publisher]
Abstract There is increasing evidence on the association of monosymptomatic nocturnal enuresis (MNE) with obstructive sleep apnea. In this communication, we share our experience of four patients with Primary monosymptomatic nocturnal enuresis (PMNE) with positive Sleep-related breathing disorder (SRBD) score who underwent detailed polysomnography, and were either refractory to desmopressin treatment or relapsed on discontinuation of desmopressin. PMID: 29845962 [PubMed - in process]
Conclusion: OSA is highly prevalent (9.6%) in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.
Introduction: Attention deficit hyperactivity disorder (ADHD) is a common behavior disorder that affects school age children. Approximately 5-7% of school-age children worldwide are diagnosed with ADHD. The pathophysiology of ADHD is complex, with some sleep disorders frequently reported as co-morbid conditions. These include obstructive sleep apnea (OSA), periodic limb movement disorder, and enuresis. OSA is a leading co-morbid condition to ADHD, and may even be a main contributor as repetitive hypoxemia and hypercapnia at night is associated with cognitive dysfunction during the day.
To investigate the beneficial effect of adenotonsillectomy (AT) on nocturnal enuresis (NE) in children with adenotonsillar hypertrophy and evaluate the Modified Pediatric Epworth Scale (MPES).
We describe a case series of 5 adult patients in whom OSA was diagnosed by laboratory polysomnography, who presented with enuresis that resolved after treatment with continuous positive airway pressure (CPAP). All cases occurred in the setting of obesity, in addition to other known risk factors for urinary incontinence and enuresis. OSA was diagnosed as severe in all but one case, which was mild. One patient noted recurrence of enuresis that coincided with malfunction of his CPAP machine. There is growing evidence that CPAP therapy may alleviate OSA and enuresis in adults with both conditions. Clinicians should routinely a...
We examined whether allergic disease and SDB were associated with childhood NE.MethodsData were assessed from the 2007 –2012 Taiwan National Health Insurance Research Database. We enrolled 4308 children aged 5–18 years having NE diagnosis and age- and sex-matched 4308 children as the control group. The odds ratios of NE were calculated to determine an association with preexisting allergic disease and SDB.ResultsA total of 8616 children were included in the analysis. Prevalence of allergic diseases and SDB was significantly higher for the NE group than the control group (allp
In conclusion, we have made progress in our understanding of pediatric OSA, and we can even recognize factors leading to its development or worsening. However, pediatricians and pediatric subspecialists are often unaware of the advances and the remedies available. PMID: 28738322 [PubMed - in process]
ConclusionsNocturnal enuresis is associated with multiple possible co‐factors in all populations with majority reporting use of sedating medications. NE is associated with significant symptom bother and impacts greatly on QoL.