There is a high comorbidity between nocturnal enuresis, sleep disorders and psychological problems. This study investigates whether a decrease in nocturnal diuresis volume not only improves enuresis, but also ameliorates the major comorbidities : disrupted sleep and (neuro)psychological dysfunction.

In this open-label, prospective phase IV study, 30 children with monosymptomatic nocturnal enuresis underwent standardized video-polysomnographic testing and multi-informant (neuro)psychological testing at baseline and six months after the start of desmopressin treatment in the University Hospital Ghent, Belgium. Primary endpoints were the effect on sleep and (neuro)psychological functioning. The secondary endpoint was the change in the first undisturbed sleep period or the time to the first void.

Thirty children between six and 16 years (mean 10.43, SD 3.08) completed the study. The study demonstrated a significant decrease in periodic limb movements during sleep (F[1,26]=122.50, P<0.001 [95% CI, −6.26 to −3.27]) and a prolonged first undisturbed sleep period (proportional hazards for time 0.04 [95% CI, 0.2 to 0.11] [z= −6.408, P<0.001]). Additionally (neuro)psychological functioning was improved on several domains.

The study demonstrates that the degree of comorbidity symptoms is at least aggravated by the enuresis (and/or high nocturnal diuresis-rate), since sleep and (neuro)psychological functioning were significantly ameliorated by successful treatment of enuresis. Although the results should be confirmed in a larger patient group, the findings suggest that monosymptomatic nocturnal enuresis is not such a benign condition as has previously been assumed.

Clinical Trials.gov NCT01645475