First uninterrupted sleep period in children and adolescents with nocturnal enuresis: Added value in diagnosis and follow-up during therapy

被引:1
作者
Karamaria, Sevasti [1 ]
Dhondt, Karlien [2 ]
Everaert, Karel [3 ]
Mauel, Reiner [4 ]
Norgaard, Jens Peter [5 ]
Raes, Ann [6 ]
Van Herzeele, Charlotte [7 ]
Verbakel, Irina [3 ]
Vande Walle, Johan [1 ,6 ]
机构
[1] Univ Ghent, Dept Internal Med & Pediat, Ghent, Belgium
[2] Ghent Univ Hosp, Pediat Sleep Ctr, Dept Child & Adolescent Psychiat, Ghent, Belgium
[3] Ghent Univ Hosp, Dept Urol, Ghent, Belgium
[4] Brussels Univ Hosp, Dept Pediat Intens Care, Brussels, Belgium
[5] Aarhus Univ, Dept Urol, DK-8000 Aarhus, Denmark
[6] Ghent Univ Hosp, Dept Pediat Nephrol, Ghent, Belgium
[7] AZ Sint Jan Brugge, Brugge, Belgium
关键词
children; desmopressin; enuresis; first interrupted sleep period; sleep; QUALITY-OF-LIFE; LIMB MOVEMENTS; DESMOPRESSIN; POLYURIA; DIURESIS; STANDARDIZATION; TERMINOLOGY; POPULATION; MANAGEMENT; FREQUENCY;
D O I
10.1002/nau.25322
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: The first uninterrupted sleep period (FUSP, time up to the first episode of enuresis/nocturia after falling asleep) is a frequently investigated parameter in adults with nocturia, as it correlates with quality of life. However, it has not been included in pediatric enuresis studies. Aim: Investigate FUSP, circadian renal water and sodium handling, as well as sleep quality before and after desmopressin therapy in enuresis. Materials and Methods: We conducted a post hoc analysis of a prospective study in 30 treatment -naive children with enuresis who underwent a video- polysomnography and a 24-h urine concentration profile before and after 6 months of desmopressin therapy. We analyzed FUSP, periodic limb movements in sleep (PLMS), and arousal indexes and their correlations with the urinary parameters.Results: Sixteen children with a mean age of 10.9 +/- 3.1 years had full registrations and were included in this subanalysis. After therapy, FUSP was significantly longer (p < 0.001), and the PLMS index was lower (p = 0.023). Significant differences in the circadian rhythm of diuresis (night/day diuresis, p = 0.041), nocturnal urinary osmolality (p = 0.009), and creatinine (p = 0.001) were found, demonstrating the increase of urinary concentration overnight by desmopressin, as well as a significant antidiuretic effect (diuresis [p = 0.013] and diuresis rate (p = 0.008). There was no correlation between the difference of FUSP, PLMS index, and urinary parameters. Nevertheless, despite this study being underpowered, there are indications of a correlation between nocturnal diuresis and diuresis rate. Results: Our results support the need for further research regarding FUSP in children with enuresis, in accordance with nocturia studies in adults, as this parameter could be valuable in the follow-up and evaluation of therapeutic strategies for enuresis.
引用
收藏
页码:1147 / 1154
页数:8
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