Relationship between sleep patterns, sleep problems, and childhood enuresis

Objective: Sleep dysfunction has been speculated to be involved in the pathological mechanism of nocturnal enuresis (NE). However, results obtained from previous studies were conflicting. This study evaluated and compared the sleep patterns and problems between children with and without nocturnal enuresis (NE) across different age and gender groups in a large epidemiological study. Methods: A multi-center, cross-sectional, epidemiological study was carried out in which 21,439 primary school children (10,655 boys and 10,784 girls aged 5.1-12.9 years) and their parents participated. Chinese versions of the Children's Sleep Habits Questionnaire and the General Condition Questionnaire were used to identify nocturnal enuresis, sociodemographic characteristics, sleep patterns, and sleep problems in children. The sleep patterns and problems were compared between children with and without NE while controlling for a number of confounding factors in different age and gender groups. Results: It was observed that children with NE (especially boys aged 11-12 years with severe NE) slept for a shorter period and were more likely to have sleep problems such as bedtime resistance, sleep duration disorder, night awakening, sleep anxiety, sleep-disordered breathing, and daytime sleepiness than those without NE. Girls with NE were more likely to suffer from other types of parasomnias. Conclusion: Children with NE, especially older boys with severe NE, were more sleep compromised than those without NE. Our findings warrant further research on the mechanism of NE and may have clinical implications for the treatment of childhood sleep problems and NE. (C) 2018 Elsevier B.V. All rights reserved.