Sleep difficulties are common in children with nocturnal enuresis (NE). Actigraphy studies in children with NE found longer sleep latency and more nighttime awakenings. Daytime motor activity has not been studied so far in children with daytime urinary incontinence (DUI) or with NE. Therefore, the aim was to assess sleep quality and daytime activity in children with DUI and/or NE objectively and reliably.
Patients with NE or DUI, diagnosed according to ICCS guidelines, and a control group were asked to wear an actigraph watch for 4 days and nights. The watch measures sleep latency, sleep efficiency, nighttime awakenings and the intensity of daytime activity. Further, an IQ test was conducted and all children were screened for psychological symptoms by the CBCL, for psychiatric disorders by a parental interview. Preliminary data of 9 patients (mean age=8.5 years, 66.7% boys) and 5 controls (11.3 years, 40% boys) are presented.
6 patients had monosymptomatic NE, 3 had additional DUI. 33.3% of patients had a clinical CBCL total score (vs. 0% in patients). First analyses showed no significant differences between patients and controls regarding mean sleep efficiency (88.5% vs. 89.2%), mean time of wake of sleep onset (WASO) (42.0 vs. 41.2 minutes), nighttime awakenings (17.2 vs. 16.4), mean awakening time (2.4 vs. 2.6 minutes) and sedentary daytime activity (40.3% vs. 44.3% per day). There is a statistical trend for increased mean daily steps in patients vs. controls (14,676 vs. 11,601, p=.076). Internalizing symptoms were significantly associated with WASO and nighttime awakenings.
First data showed no major differences in sleep parameters in this ongoing study. Daytime activity results indicate that patients are more active which could be possibly related to comorbid psychiatric disorders, e.g. ADHD. Internalizing symptoms (anxiety and depression) influence sleep quality and may be associated with urinary problems.