Lamia Medhat Afi fi
Cairo University, Egypt
Title: Polysomnography and anti-diuretic hormone secretion pattern in children with primary nocturnal enuresis
Biography
Biography: Lamia Medhat Afi fi
Abstract
Background: Data regarding sleep patterns in nocturnal enuresis (NE) and its relation to anti-diuretic hormone (ADH) secretion pattern is defi cient. Normally, ADH secretion is increased at night compared to morning so that urine volume decreases during sleep. NE can be caused by nocturnal polyuria due to ADH defi ciency or detrusor muscle hyperactivity. We aimed to evaluate the ADH secretion pattern in children with primary NE and compare the polysomnography (PSG) fi ndings between children with a normal ADH secretion pattern to those with a reversed secretion pattern. Subjects & Methods: Th is study included 28 children, aged 6-18 years with primary mono-symptomatic severe NE. Th ey were subjected to a single overnight attended full PSG. Assay of ADH levels was performed at 9-11 am and 9-11 pm. Results: Reversal of circadian rhythm of ADH secretion was present in 23 children (82%) and normal rhythm was present in 5(18%). PSG revealed that children with reversed ADH rhythm showed less stage N1 percentage and higher sleep effi ciency than the group with normal ADH rhythm. Th e apnea hypopnea index and periodic limb movements’ indices were similar between both groups. Conclusion: Reversed ADH secretion pattern is very frequent in children with NE. Children with reversed ADH secretion had a higher sleep effi ciency than NE children with a normal pattern implying that children with nocturnal polyuria have a more consolidated sleep than those with detrusor muscle hyperactivity.