Faculty of Medicine, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada.
J Urol. 2011 Oct;186(4 Suppl):1710-3. doi: 10.1016/j.juro.2011.04.017.
Enuresis is 1 of the most common complaints facing pediatric urologists and it has significant implications with respect to quality of life. Although the pathophysiology is incompletely understood, there is growing evidence that sleep disordered breathing in children, including obstructive sleep apnea, has a fundamental role. There are also potentially fundamental differences between monosymptomatic enuresis, which may be a sleep disorder, and nonmonosymptomatic enuresis, which may relate to a primary bladder storage problem. We prospectively evaluated the incidence of obstructive sleep apnea in patients with enuresis and analyzed differences between patients with monosymptomatic and nonmonosymptomatic enuresis.
A total of 69 children with enuresis were given 3 validated questionnaires to complete, including the Dysfunctional Voiding and Incontinence Symptom Score, the Obstructive Sleep Apnea Quality of Life survey and the Modified Pediatric Sleep Questionnaire. The Dysfunctional Voiding and Incontinence Symptom Score quantifies patient dysfunctional voiding habits. The Obstructive Sleep Apnea Quality of Life survey evaluates patient quality of life in regard to obstructive sleep apnea and its effects. Modified Pediatric Sleep Questionnaire results describe the severity of patient sleep disturbances.
The mean Obstructive Sleep Apnea Quality of Life Survey score was 43 and 54% of patients had positive Modified Pediatric Sleep Questionnaire results, indicating that obstructive sleep apnea was prevalent in our population. Those with enuresis and daytime incontinence were significantly more likely to have sleep disordered breathing than those with monosymptomatic enuresis (p <0.05).
Our study confirms the link between sleep disordered breathing and enuresis. All pediatric health care providers should be aware of this risk. The risk may be magnified in patients with concomitant daytime incontinence.
遗尿是小儿泌尿科医生面临的最常见问题之一，它对生活质量有重大影响。尽管其病理生理学尚未完全了解，但越来越多的证据表明，儿童睡眠呼吸障碍，包括阻塞性睡眠呼吸暂停，具有根本作用。遗尿症也可能是一种睡眠障碍，非遗尿症可能与原发性膀胱储存问题有关，两者之间可能存在潜在的根本区别。我们前瞻性地评估了遗尿症患者中阻塞性睡眠呼吸暂停的发生率，并分析了单纯性遗尿症和非单纯性遗尿症患者之间的差异。
共 69 例遗尿症患儿接受了 3 项经验证的问卷评估，包括排尿功能障碍和尿失禁症状评分、阻塞性睡眠呼吸暂停生活质量调查和改良小儿睡眠问卷。排尿功能障碍和尿失禁症状评分量化了患者排尿功能障碍习惯。阻塞性睡眠呼吸暂停生活质量调查评估了患者阻塞性睡眠呼吸暂停及其影响的生活质量。改良小儿睡眠问卷结果描述了患者睡眠障碍的严重程度。
阻塞性睡眠呼吸暂停生活质量调查评分的平均值为 43，54%的患者改良小儿睡眠问卷结果阳性，表明阻塞性睡眠呼吸暂停在我们的人群中很常见。遗尿伴日间尿失禁的患者发生睡眠呼吸障碍的可能性明显高于单纯性遗尿症患者（p<0.05）。
我们的研究证实了睡眠呼吸障碍与遗尿症之间的联系。所有儿科保健提供者都应该意识到这种风险。在伴有日间尿失禁的患者中，这种风险可能会更大。
