TY - JOUR T1 - Nocturnal enuresis as risk factor for moderate-to-severe OSA in children with snoring JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P4912 AU - Emmanouel Alexopoulos AU - Georgia Malakasioti AU - Vasiliki Varlami AU - Michail Miligkos AU - Konstantinos Gourgoulianis AU - Athanasios Kaditis Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P4912.abstract N2 - Objective: Conflicting data indicate that frequency of monosymptomatic primary nocturnal enuresis (NE) may increase in parallel with severity of obstructive sleep apnea (OSA) in childhood. In the present study, it was hypothesized that NE is associated with increased risk of moderate-to-severe OSA (apnea-hypopnea index-AHI>5 episodes/h) among children with snoring referred for polysomnography. Methods: Data of children with snoring and age ≥ 5 years who were referred for a sleep study by primary care physicians over a period of 12 years were reviewed. Results: Data of 525 children with mean age (± standard deviation) 7.5 (± 2.2) years and median AHI (10th-90th percentiles) 1.9 episodes/h (0.4-7.3 episodes/h) were analyzed. Three hundred and fifty five of the 525 children (67.6%) had NE (urine incontinence ≥ 1 night/week) and 87 (16.6%) had moderate-to-severe OSA. There was no interaction between NE and gender regarding the association with moderate-to-severe OSA (P=0.06). NE was associated with presence of moderate-to-severe OSA after adjustment for tonsillar hypertrophy, obesity, gender and age [adjusted OR = 1.92 (1.08-3.43); p=0.03]. Presence of NE had high sensitivity (78.2%) and low positive predictive value (19.2%) for detecting moderate-to-severe OSA along with low specificity (34.5%) and high negative predictive value (88.8%) for ruling it out. Conclusions: Children with snoring and without NE referred for polysomnography are less likely to have OSA of more than mild severity compared to those with NE. ER -