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.