title: Sleep disturbances associated with sleep enuresis: A questionnaire study.
abstract: OBJECTIVE
  Sleep enuresis (SE) is the second most common sleep complaint in childhood. It has been associated with bladder hyperactivity, excessive urine production and deeper sleep. Several sleep disorders have been described in association with SE like parasomnias and sleep apnea. The aim of this study was to analyze the presence of sleep disturbances in children with SE through the use of Sleep Disturbance Scale for Children (SDSC) compared to normal children matched for age and sex.
  
  
  METHODS
  A questionnaire evaluation was performed in 76 enuretic and 112 normal children through the Sleep Disturbance Scale for Children (SDSC) validated for Portuguese language. The Scale is grouped into six subscales: Disorders in Initiating and Maintaining Sleep (DIMS), Sleep Breathing Disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders Of Excessive Somnolence (DOES), and Nocturnal Hyperhidrosis (SHY). Children with renal and neurological problems were excluded from both groups.
  
  
  RESULTS
  Enuretics scored higher in several of the subscales (SBD, DOA, SWTD) and also in the total scale scores while scored low in the DIMS subscale. No differences were found for the DOES and SHY subscales.
  
  
  CONCLUSIONS
  Enuretic children showed a high comorbidity with other sleep disturbances like sleep disordered breathing and parasomnias. The novel finding of this study is that we found a decreased incidence of DIMS that is consistent with the parental perception of a more deep sleep and a high arousal threshold in SE.
authors.affiliation: Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Department of Pediatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil. Electronic address: leticia.soster@usp.br.
authors.forename: Leticia
authors.initials: L
authors.lastname: Azevedo Soster
authors.affiliation: Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Rosana
authors.initials: R
authors.lastname: Alves
authors.affiliation: Department of Pediatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Simone N
authors.initials: SN
authors.lastname: Fagundes
authors.affiliation: Department of Pediatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Vera H K
authors.initials: VHK
authors.lastname: Koch
authors.affiliation: Department of Developmental and Social Psychology, Sapienza University, Rome, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053206:Nocturnal Enuresis / Q000150:complications* / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Parasomnia; Questionnaire; Sleep disordered breathing; Sleep disturbance scale for children; Sleep enuresis