I read with interest the recent article by Anyanwu,
et al. [1] published in Indian Pediatrics and have
following comments to offer:
The association of sleep disorders and nocturnal
enuresis have been established in previously published reports. A
retrospective study of the 525 children with snoring refereed for
polysomnography found that 67.7% of these children had nocturnal
enuresis [2]. The authors of present article [1] also found that
nocturnal enuresis was significantly associated with poor sleep hygiene.
A systematic review of 14 studies found that sleep-disordered breathing
is associated with nocturnal enuresis and adeno-tonsillectomy was
associated with significant improvement in enuresis [3].
In the present study, it would have been interesting
to know the presence of sleep-disordered breathing in the patients
having enuresis by using appropriate scales. Moreover, as the study
intended to find out the association of nocturnal enuresis with sleep,
we expected the authors to have subjected enuretic children to Pediatric
sleep questionnaire (PSQ) to find out the prevalence of
sleep-disorders/sleep-disordered breathing. These findings are important
as children having nocturnal enuresis along with obstructive sleep apnea
may require different therapeutic interventions [4].
References
1. Anyanwu OU, Ibekwe RC, Orji ML. Nocturnal
enuresis among Nigerian children and its association with sleep,
behavior and school performance. Indian Pediatr. 2015;52:587-9.
2. Alexopoulos EI, Malakasioti G, Varlami V,
Miligkos M, Gourgoulianis K, Kaditis AG. Nocturnal enuresis is
associated with moderate-to-severe obstructive sleep apnea in children
with snoring. Pediatr Res. 2014;76: 555-9.
3. Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell
R. The association between sleep-disordered breathing and enuresis in
children. Laryngoscope. 2012;122:1873-7.
4. Jain S, Bhatt GC. Advances in the management of
primary monosymptomatic nocturnal enuresis in children. Paediatr Int
Child Health. 2015:2046905515Y0000000023.