![]() We hypothesized that children undergoing AT would be more likely to experience improvement in NE than children managed with watchful waiting. 16 The primary objective of our project was to assess the outcomes associated with AT in children with NE and nonsevere OSA. We sought to better understand the interplay between bed-wetting and pediatric OSA by analyzing data from the Childhood Adenotonsillectomy Trial (CHAT). 2, 14, 15 However, given that the natural history of NE is characterized by spontaneous resolution, the lack of randomized studies on this topic makes it difficult to determine whether AT confers additional benefit. Research has pointed to a reduction in NE in children with OSA following AT. 3 The primary treatment for children with OSA is adenotonsillectomy (AT). ![]() However, adherence to these management strategies is often poor, resulting in refractory NE. 13įirst-line therapy of NE is behavioral modification in conjunction with either bed alarm or desmopressin therapy. 10, 11, 12 The mechanism linking OSA to NE has not been fully elucidated however, it is proposed that airway obstruction leads to changes in intrathoracic pressure that cause activation of cardiopulmonary and renal neuroendocrine reflexes. 8, 9, 10 Studies have reported that children with OSA have a higher prevalence of NE than their healthy peers. 5, 7 Obstructive sleep apnea has been linked to decreased quality of life, neurocognitive and behavioral impairment, and the development of cardiovascular disease. 6 One known risk factor for NE is obstructive sleep apnea (OSA), a disease characterized by upper airway collapse during sleep. The source of NE is multifactorial and features increased nocturnal urine production, failure to awaken from sleep, and bladder hyperactivity. 3, 4 Although NE has a spontaneous resolution rate of 15% per year, approximately 3% of NE cases will persist into adulthood. 2 Nocturnal enuresis is associated with diminished self-esteem and the emergence of childhood psychological problems. 1 Nocturnal enuresis is defined as discrete episodes of urinary incontinence that occur during sleep in children at least aged 5 years. Nocturnal enuresis is the second most common chronic medical condition affecting children and is present in approximately 5% to 10% of otherwise healthy children aged 7 years. Nocturnal enuresis (NE), also called bed-wetting, involves involuntary urination during sleep.
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