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.
Investigate FUSP, circadian renal water and sodium handling, as well as sleep quality before and after desmopressin therapy in enuresis.
We conducted a post hoc analysis of a prospective study in 30 treatment-naïve 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.
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.
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.
Neurourology and urodynamics. 2023 Nov 06 [Epub ahead of print]
Sevasti Karamaria, Karlien Dhondt, Karel Everaert, Reiner Mauel, Jens Peter Nørgaard, Ann Raes, Charlotte Van Herzeele, Irina Verbakel, Johan Vande Walle
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium., Department of Child and Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Pediatric Intensive Care, Brussels University Hospital, Brussels, Belgium., Department of Urology, Aarhus University, Aarhus, Denmark., Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium., AZ Sint Jan Brugge, Brugge, Belgium.