Desmopressin Melt: Impact on Sleep and Daytime Functioning
Status:
Completed
Trial end date:
2012-08-01
Target enrollment:
Participant gender:
Summary
Nocturnal enuresis affects 10% of the 7-year-old children and is essentially caused by a
mismatch between nocturnal bladder capacity and the amount of urine produced during the night
together with failure of the child to awaken in response to a full bladder.Urine
overproduction at night or nocturnal polyuria (NP) is a major factor contributing to
monosymptomatic nocturnal enuresis (MNE) pathophysiology in a large proportion of patients.
Since NP is related to an abnormal circadian rhythm of arginine vasopressin (AVP) secretion,
the synthetic AVP analogue desmopressin is widely used to treat MNE.
It is recommended by the International Consultation on Incontinence (grade A,level 1).
Desmopressin is available in 3 different formulations: nasal spray, tablet and the newest
form melt.
Baeyens et al demonstrated an increased prevalence of attention deficit-hyperactivity
disorder (ADHD) in children with MNE According to recent data there is a high incidence of
periodic limb movements in sleep at night in children with nocturnal enuresis. Those children
have an increased cortical arousability leading to awakening.
The frequent awakening most likely has an influence on concentration and other ADHD-symptoms
in daily life.
This study will assess the impact of desmopressin melt on prepulse inhibition, ADHD-symptoms,
cognition and learning, sleep, quality of life and self esteem.
New patients aged 6-16 years with monosymptomatic nocturnal enuresis, nocturnal polyuria and
sleep problems are tested before the start of the study medication desmopressin melt (T1) and
6 months later (T2). It is a multi-method, multi-informant study.