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Clinical Summary

OSA is common among children with nocturnal enuresis

Takeaway

  • Almost 70% of school-aged children (>5-16 years old) with nocturnal enuresis (NE) have obstructive sleep apnoea (OSA).
  • The link is especially common with obesity.

Why this matters

  • School-aged children with NE should undergo polysomnography.
  • OSA treatment has the potential to reduce NE.

Study design

  • 54 children with NE agreed to undergo full-night polysomnography.
  • OSA was defined by obstructive apnoea/hypopnoea index (AHI) ≥2 episodes per hour.
  • Obesity was defined as BMI ≥95th percentile.
  • Funding: None disclosed.

Key results

  • 68.5% of the cohort (n=37 of 54) had OSA with:
    • Median obstructive AHI: 6.1 (95% CI, 3.7-13.2) vs 1.3 (95% CI, 0.68-1.6) episodes/hour in children with non-OSA (P<.0001).
    • Median oxygen saturation of 97.1% vs 97% (P=.844).
    • Oxygen saturation nadir of 88% vs 90.5% (P=.03).
  • 33% of the cohort (18/54) had obesity with higher AHI: 7.0 (95% CI, 3.7-12.4) vs 2.4 (95% CI, 1.3-6.1) episodes/hour in patients without obesity (P=.023).
  • Sleep clinical record score was significantly correlated with AHI (r2=0.462; P=.001) with 91% sensitivity of detecting OSA ≥5 episodes/hour.
  • OSA was also associated (ORs) with:
    • Nasal obstruction: 4.0 (P=.034).
    • Facial phenotype: 2.0 (P=.056).
    • Arched palate: 2.4 (P=.013).
  • OSA was not associated with tonsillar hypertrophy or oral breathing.

Limitations

  • Small sample size.
  • Observational design.
  • Only 1 questionnaire to assess sleep breathing difficulties.

References


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