AUA 2018: Improved Sleep Quality Following Adenotonsillectomy is Associated with Enuresis Resolution in Children with Sleep Disordered Breathing

San Francisco, CA ( In this prospective pilot study, researchers analyzed how adenotonsillectomy (TA) in children would affect their overall sleep quality, nocturnal urinary volume, and secretion of antidiuretic hormone (ADH) and brain natriuretic peptide (BNP). 

Previous research suggests that about 50% of children with sleep-disordered breathing do not report new cases of nocturnal enuresis post-surgery, but mechanisms are not clear. This study attempts to evaluate other effects of TA surgery. 

41 children ages 5 to 18 were enrolled in the study.  Eligibility criteria included diagnosis of sleep-disordered breathing (snoring and obstructive sleep apnea) and concurrent nocturnal enuresis (See Table 1). 

Improved Sleep Quality 1

The research team has measured plasma levels ADH and BNP, number of nocturic episodes, nighttime urinary volume and arousal score pre and 1 month post-surgery.

Research demonstrated that overall improvement of sleep quality decreased enuresis in children ages 5-12 after the surgery (Table 2). Interestingly, nighttime voiding episodes have increased. Kovacevic states that these data can be explained by eliminating airway obstruction. As a result, brain receives more oxygen, and children are more likely to wake up to void rather than having enuretic episodes. There were no significant change in hormone levels and nighttime urine volume.

Improved Sleep Quality 2

This research confirmed previous findings of resolution of enuresis in children undergoing adenotonsillectomy. It is also demonstrated that improvement in the quality of sleep is one of the contributing factors behind decrease of enuretic episodes.

Presented by: Larisa Kovacevic, MD, Department of Pediatric Urology, Children’s Hospital of Michigan, Detroit, MI
Co-authors: Hong Lu, Yegappan Lakshmanan

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology,, University of Pennsylvania, @PennUrology at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA
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