Modulation of arousal reaction in children with nocturnal enuresis

Background: Disturbances of central regulatory processes of sleep and arousal are potential causes of nocturnal enuresis.The intranasal application of an ADH analogue is an established therapeutic option to influence nocturnal enuresis. The aim of the study was to evaluate effects of an ADH analogue on sleep and arousal in patients suffering from primary nocturnal enuresis. Patients and Methods: In our study the influence of ADH analogue on sleep architecture was investigated by polysomnographic studies before and during therapy in 24 patients. Results: In polysomnography arousal index and movement time were significantly improved after 6 weeks, sleep stages 1 to 4 did not change significantly. Treatment reduced the frequency of nocturnal wetting significantly and this effect lasted for another 6 weeks. Conclusion: The long lasting effect of ADH to reduce enuresis could possibly be caused by changes in arousal reaction and a normal wake up facilitation.