Sleep Habits And Psychological Problems In Enuresis Nocturna

Sleep Habits And Psychological Problems In Enuresis Nocturna

INTRODUCTIONEnuresis nocturna (EN) is one of the most unpleasant problem in childhood. Functional problems thought to be the majority part of etiology instead of structural, medical or neurological problems. Psychological disorders, such as  attention deficit hyperactivity disorder, oppositional defiant disorder or depression may be accompanying with enuresis nocturna. Internalising problems such as separation anxiety, social anxiety, specific phobia, generalised anxiety, depression, conduct disorders and attention deficit hyperactivity disorder can accompany with EN. In this study, we aimed to investigate the sleep habits and psychological disturbances in children with EN. METHODSThe fourty children (27 boys and 13 girls) with EN who had been admitted to Pediatrics and Urology outpatients departments and 113 (54 boys and 58 girls) age-matched healthy controls are comprised fort he study. Participants received ‘Strengths and Difficulties Questionnaire’ (SDQ), and  ‘Children’s Sleep Habits Questionnaire’ (CSHQ).RESULTSThe frequency of sleep problems was 59% and 85% in the control and in enuretic groups. The total problem score was significantly higher in the EN group according to the scores of the SDQ parent-report form. The EN groups with regard to bedtime resistance, sleep-anxiety, night-waking, parasomnias, breathing-related problems and daytime sleepiness showed significantly higher scores in CSHQ comparing to control group.CONCLUSIONThe children with EN need to be evaluated in regarding to sleep and psychological aspect.

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  • 1. von Gontard A, Nevéus T (2006). Management of Disorders of Bladder and Bowel Control in Childhood. London: MacKeith Press.
  • 2. von Gontard A. Enuresis. In Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions 2012.
  • 3. Järvelin MR, Moilanen I, Vikeväinen-Tervonen L et al (1990). Life changes and protective capacities in enuretic and non-enuretic children. Journal of Child Psychology and Psychiatry, 31:763-774.
  • 4. Erdogan A, Akkurt H, Boettjer NK et al (2008). Prevalence and behavioural correlates of enuresis in young children. Journal of Paediatrics and Child Health, 44:297-301.
  • 5. von Gontard A, Plück J, Berner W et al (1999). Clinical behavioral problems in day and night wetting children. Pediatric Nephrology, 13:662-667.
  • 6. von Gontard A, Moritz AM, Thome-Granz S et al (2011c). Association of attention deficit and elimination disorders at school entry – a population-based study. Journal of Urology, 186:2027-2032.
  • 7. Joinson C, Heron J, Emond A et al (2007). Psychological problems in children with bedwetting and combined (day and night) wetting: A UK population-based study. Journal of Pediatric Psychology, 32:605-616.
  • 8. Goodman R. The Strengths and Difficulties Questionnaire: A Research Note. J Child Psychol Psychiatry 1997;38:581-586.
  • 9. Owens J, Spirito A, McGuinn M. The children’s sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep 2000;23:1043– 1051.
  • 10. Fiş NP, Arman A, Ay P, A Topuzoğlu, AS Güler, SG İmren, et al. Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Dergisi 2010;11:151-160.
  • 11. Abou-Khadra MK, Amin OR, Ahmed D. Association between sleep and behavioural problems among children with enuresis. J Paediatr Child Health. 2013;49(2):160-6.
  • 12. Cohen-Zrubavel V, Kushnir B, Kushnir J, Sadeh A. Sleep and sleepiness in children with nocturnal enuresis. Sleep 2011; 34: 191–4.
  • 13. 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(6):555-559.
  • 14. Sans Capdevila O, Crabtree VM, Kheirandish-Gozal L, Gozal D. Increased morning brain natriuretic peptide levels in children with nocturnal enuresis and sleep-disordered breathing: a community-based study. Pediatrics. 2008;121(5):1208–1214.
  • 15. von Gontard A, Mauer-Mucke K, Pluck J, Berner W, Lehmkuhl G. Clinical behavioral problems in day- and night-wetting children. Pediatr Nephrol 1999;13:662–667.
  • 16. Ellington EE, McGuinness TM. Mental health considerations in pediatric enuresis. J Psychosoc Nurs Ment Health Serv. 2012; 50(4):40–45.