What does sleep apnea have to do with bed-wetting in children?

Bed-wetting, or nocturnal enuresis, is a common issue that affects many children. It refers to the involuntary release of urine during sleep after the age when bladder control is expected to be established. 

Bed-wetting is often considered a normal part of a child’s development, affecting around 1 in 5 kids between ages 4 and 12. But bed-wetting can sometimes be linked to an underlying medical condition. One such condition is sleep apnea, a disorder characterized by repeated interruptions in breathing during sleep. 

What is sleep apnea? 

Sleep apnea is a condition that occurs when the upper airway becomes partially or completely blocked during sleep, leading to pauses in breathing. These pauses, known as apneas, can last for a few seconds up to a minute. And they can occur many times throughout the night. 

Consequently, oxygen levels in the blood drop. And the brain sends signals to briefly wake up the sleeping person to restore normal breathing. These awakenings are often so brief that people are unaware they’re happening. But they disrupt the sleep cycle and prevent deep, restorative sleep.

In children, sleep apnea is most commonly caused by enlarged tonsils and adenoids, which can obstruct the airway. The condition can manifest in various ways, including…

• Loud snoring
• Restless sleep
• Frequent tossing and turning
• Night sweats
• Mouth breathing
• Bed-wetting

Not all children with sleep apnea experience bed-wetting, however. But there is a significant correlation between the two.

What’s the connection between sleep apnea and bed-wetting? 

The connection between sleep apnea and bed-wetting lies in the effect that sleep-disordered breathing has on the body’s ability to regulate urine production and bladder control. During sleep, the body produces a hormone called antidiuretic hormone (ADH). This hormone helps reduce urine production. And it allows the bladder to hold urine for longer periods.

However, in children with sleep apnea, the disrupted sleep pattern can interfere with the release of ADH. And this can lead to increased urine production and reduced bladder control.

Additionally, the fragmented sleep caused by sleep apnea can contribute to bed-wetting by affecting a child’s arousal response to a full bladder. Normally, the brain receives signals from the bladder indicating the need to wake up and empty it. But in children with sleep apnea, these signals may be dulled or ignored due to ongoing sleep disruptions. Consequently, the child may not wake up when their bladder is full, resulting in bed-wetting episodes.

Not all cases of bed-wetting in children are related to sleep apnea. Bed-wetting can have various causes. These include…

• Genetics
• Delayed bladder maturation
• Psychological factors
• Dietary habits

But if a child experiences persistent bed-wetting combined with other symptoms suggestive of sleep apnea, parents should talk to a healthcare professional for further evaluation.

How to diagnose pediatric sleep apnea

Diagnosing pediatric sleep apnea typically involves a sleep study, also known as polysomnography, which monitors various bodily functions during sleep. If sleep apnea is confirmed, the primary treatment approach is to remove the tonsils and adenoids. This often resolves breathing issues and improves sleep quality. But in some cases, other interventions, such as continuous positive airway pressure (CPAP) therapy, may be necessary.

Addressing sleep apnea helps reduce the associated symptoms. Plus, it can lead to a significant improvement in bed-wetting. By restoring normal sleep patterns and promoting uninterrupted breathing, treatment for sleep apnea can positively impact bladder control. And it can reduce the occurrence of bed-wetting.

While bed-wetting is a common childhood issue, it can sometimes be linked to an underlying sleep disorder like sleep apnea. The breathing disruptions and sleep patterns caused by sleep apnea can affect the body’s hormone regulation and bladder control mechanisms. And this can lead to an increased likelihood of bed-wetting. 

Parents and healthcare professionals should recognize the connection between sleep apnea and bed-wetting. That way, they can seek and provide appropriate evaluation and treatment options. And they can improve the quality of life for affected children. 

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website: MeghnaDassani.com.