Abstract
Objectives: To detect and raise the attention to the problem of obstructive sleep apnea (OSA) among the school-age children presented with nocturnal enuresis (NE).
Methods: Sixty-three children >5 years presented with NE were enrolled in the study (35 Egyptian and 28 Italian). Children with evidence of urinary tract infection or anatomical abnormalities, intellectual disabilities, psychological issues and diabetes mellitus were excluded. All the children were clinically examined and scored using sleep clinical record score (SCR) adapted by Villa et al in 2013 (Eur Respir J 2013;41:55–61) as SCR ≥ 6.5 is considered positive. Then the patients were subjected for full night polysomnogram (PSG). Children with apnea/hypopnea index (AHI) ≥1 events/hour were considered as OSA.
Results: Twelve Egyptian children refused to undergo the PSG. Fifty-one children aged 8.2±2.8 years underwent the PSG where 87.5% had OSA with AHI of 9.2±11.8 events/hour. Fifty-seven percent had OSA≥3 events/hour. The average oxygen saturation was 96.6±1.6% and nadir was 86.2±8.2%. SCR score correlated significantly with AHI (p=0.004) with mean SCR score of 7.44±2.78 points with 75% sensitivity in detecting OSA≥3. Thirty-one percent were obese with significantly higher AHI (12.2±15.9 vs. 6.1±8.6; p=0.035) that positively correlated with AHI (r= 0.301,p=0.035). Dental/skeletal malocclusions, arched palate and nasal obstruction were more prevalent with OSA (60.8%, 51% & 51% respectively) rather than tonsillar hypertrophy and oral breathing (19.6% & 27.5% respectively).
Conclusions: NE is commonly associated with OSA especially in the obese children. Skeletal malocclusions and nasal obstruction were commonly associated with OSA and NE.
- Copyright ©the authors 2016
