Sleep enuresis

Rosalia C Silvestri MD (Dr. Silvestri is Director of the Interdepartmental Sleep Center at the University of Messina in Italy and has no relevant financial relationships to disclose.)
Antonio Culebras MD, editor. (Dr. Culebras of SUNY Upstate Medical University has no relevant financial relationships to disclose.)
Originally released November 11, 1994; last updated January 3, 2017; expires January 3, 2020

This article includes discussion of sleep enuresis, nocturnal enuresis, enuresis nocturna, nocturnal bedwetting, familial enuresis, functional idiopathic enuresis, symptomatic enuresis, and essential enuresis. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

The author points out how therapeutic strategies stress a combined pharmacologic/behavioral approach for therapy-resistant enuresis, especially when psychiatric comorbidity is diagnosed.

Key points

 

• Primary nocturnal enuresis is a common parasomnia often comorbid with neurodevelopmental disorders.

 

• A combination of pharmacological treatment and behavioral therapy with the aid of mechanical alarm devices is highly successful at almost any age.

 

• Social embarrassment and stigmata may be easily overcome by appropriate management.

Historical note and terminology

One of the most prevalent and distressing of the childhood parasomnias, sleep enuresis has been discussed in medical papers since 1550 BC (Glicklich 1951). Understanding of the problem has developed slowly, and many enuretic children remain untreated or are treated ineffectively.

Early sleep research suggested that enuresis occurred as a "dream equivalent" (Pierce et al 1961). Later, Broughton proposed that enuresis is a disorder of arousal, originating in the deepest NREM sleep stage (Broughton 1968), but Mikkelsen and Rapoport demonstrated that enuretic episodes occur more or less randomly throughout the night, independent of sleep stage (Mikkelsen and Rapoport 1980).

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.