Intranasal Steroids for the Treatment of Nocturnal Enuresis With Associated Obstructive Sleep Apnea
Status:
Withdrawn
Trial end date:
2016-06-01
Target enrollment:
Participant gender:
Summary
Enuresis (E) or bedwetting is a common pediatric complaint, and recent research has
discovered a link with obstructive sleep apnea (OSA). In children, OSA is often secondary to
enlargement of their adenoids or tonsils, and is often successfully treated with a steroid
solution given through the nose.
The relationship between SDB and E is incompletely understood. Airway obstruction affects the
quality of sleep, as the child will wake as the oxygen levels drop. Abnormal sleep also can
decrease the secretion of hormones that affects the kidney's ability to concentrate urine at
night, which can result in too much urine in the bladder. Contemporary evidence also suggests
that patients with enuresis have abnormal sleep phases, which may impair the communications
and inhibition of the bladder.
In previous studies, the investigators have demonstrated that children with E have a high
likelihood of having concomitant SDB. The investigators have also demonstrated that children
with E and symptoms of SDB do not respond to typical management for bedwetting. Therefore,
the investigators propose to treat patients presenting with E with our standard treatments
for E (bed alarm) and first line therapy for SDB: Intranasal steroids. This medication helps
to decrease the inflammation of the adenoids and tonsils, thereby reducing the airway
obstruction. the investigators hypothesize that children with significant symptoms of SDB
will improve with the addition of INS, and the investigators hope to see an improvement in
their bedwetting, quality of life, and sleep quality as well.
To test this, patents with E will be recruited from the pediatric urology clinic. They will
be offered the standard treatment for E, the bed alarm, and the treatment group will be given
an intranasal steroid spray. The investigators will then reassess the patients 3 months after
treatment, and compare the two groups.