WASHINGTON – Adenotonsillectomy reduced obstructive sleep apnea and bed-wetting in half of 35 children diagnosed with both conditions.
The study was limited by its small size, but the findings suggest that children with severe obstructive sleep apnea and nocturnal enuresis might benefit on both counts with adenotonsillectomy, said Dr. Prasad Thottam of Children’s Hospital of Michigan, Detroit.
The average age of the children studied was 8 years, 60% were male, and their average body mass index was 24 kg/m2. Proper bladder function was documented in all of the children, and none had chronic conditions such as cerebral palsy, severe asthma, or morbid obesity. All experienced bed-wetting more than 3 nights per week. Any medications taken for nocturnal enuresis were discontinued for 1 month prior to surgery.
Four children had adenoidectomies, two had tonsillectomies, and 29 had adenotonsillectomies. After an average of 10 weeks post surgery, 51% of the children had reductions in bed-wetting, said Dr. Thottam. The reductions were most notable in children with a higher BMI and worse apnea characteristics on polysomnography.
Girls were five times more likely than were boys to have bed-wetting resolve after surgery. Children with prolonged stage 2 sleep were eight times more likely than were those with a normal duration of stage 2 sleep to have bed-wetting resolve.
In addition, when comparing the sleep architecture of the patients to established normal levels, an apnea-hypopnea index greater than 10 was associated with a higher rate of resolution of bed-wetting compared with the rest of the population.
The findings were presented at the annual meeting of the American Academy for Otolaryngology – Head and Neck Surgery Foundation. Dr. Thottam had no financial conflicts to disclose.