Increased delta component in computerized sleep electroencephalographic analysis suggests abnormally deep sleep in primary monosymptomatic nocturnal enuresis.
OBJECTIVE
The aim of this study was to investigate sleep and the sleep modulating effect of 1-desamino-8-D-arginine vasopressin (DDAVP) in patients with primary monosymptomatic nocturnal enuresis and controls by means of both conventional polysomnography and computerized electroencephalographic (EEG) power analysis.


METHODS
Adolescents or adults with primary monosymptomatic nocturnal enuresis (n = 11, 8 females, 3 males: mean age 23.0 +/- 9.8, range 15-49 years) and normal subjects (n = 10, 7 females, 3 males: mean age 23.2 +/- 5.4, range 14-32 years) were admitted to the sleep laboratory of the University Hospital of Aarhus, Denmark, for the investigation of sleep over four consecutive nights. A fixed day-to-night cycle was maintained. Night-time was defined as 23.00-07.00 h. The 1st and 3rd nights were completed without intervention. Sleep was modulated on the 2nd night by a waterload to induce nocturnal micturition. On the 4th night all subjects received DDAVP spray applied intranasally at bedtime. Sleep was evaluated by manual polysomnography according to the rules of Rechtschaffen and Kales and by computerized EEG power analysis on the 1st, 3rd and 4th nights. EEG power was calculated as total power and as power assigned to specific EEG frequency bands.


RESULTS
Enuretics showed a significant increase in the EEG delta power component during baseline sleep compared with controls, whereas no difference was encountered using a manual sleep score. During recovery sleep on the 3rd night EEG power in the enuretic group was increased in all EEG frequency bands apart from the alpha and sigma bands and associated with a shortened total sleep period. DDAVP was not found to influence sleep to any significant extent.


CONCLUSIONS
EEG power analysis indicates an increased depth of sleep in enuretics inadequately reflected by a conventional polysomnographic technique. No sleep-modulating effect of DDAVP was detected.
Hunsballe
J M
JM
International Enuresis Research Center at the Institute of Experimental Clinical Research, University of Aarhus, Denmark.
D000293:Adolescent; D000328:Adult; D001127:Arginine Vasopressin / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003700:Delta Rhythm / Q000187:drug effects; D003936:Diagnosis, Computer-Assisted; D004775:Enuresis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000187:drug effects / Q000502:physiology*
D001127:Arginine Vasopressin; D003894:Deamino Arginine Vasopressin