Published on March 8, 2014
Parasomnia Enuresis Sleep Disorders of Pediatrics and Special Populations Professor: John Murray Student: Felix Alonzo School: Northern Essex Community College
Table of Content • Definition • Etiology, Causes • Evaluation • Treatment • Age related treatment
(Table of Content (continue Stats • Age Stats Graph • Gender Stats Graph • Conclusion • Reference •
Definition Enuresis: The involuntary release of urine from • the bladder. Nocturnal enuresis refers to wetting the bed during sleep. This usually occurs during .stage N3 in the first third of the night
Etiology, Causes Anatomic problems • Diabetes insipidus • Diabetes mellitus • Endocrine dysfunction • Child abuse • Drinking habits •
(Etiology, Causes (continue Urinary tract infection • Spinal cord abnormalities with associated neurogenic • bladder Ectopic ureter in females • Posterior urethral valves in males • Psychiatric symptoms •
Evaluation • History: check family history of enuresis, check patient sleeping patterns, check patterns of when the patient wets the bed, patient medical condition, does the patient urinate during the day, how often the patient uses the bathroom during the day.
(Evaluation (continue • Physical Examination: Perform a complete examination, focus on the urogenital, neurologic and gastrointestinal system. Palpate bladder, look for signs of sexual abuse, look for signs of mouth breathing because it might indicate sleep apnea, it might indicate hypertrophy.
(Evaluation (continue Laboratory/Imaging Studies: Have urinalysis of a clean • catch midstream urine specimen done on the patient, to rule out diabetes or diabetes mellitus. Urine culture to .see if there is a urinary tract infection
Treatment • Patient needs to be willing to get treatment or be motivated, and acceptance. • Support from family is important. • Generate a treatment plan that fits the patient age group. • Building the patient self-esteem. • Develop a copying mechanism.
(Treatment (continue Pharmacotherapy: Drugs used to treat enuresis, for • example, Imipramine, Desmopressin (DDAVP), and .Oxybutynin
(Treatment (continue Imipramine: Tricyclic antidepressant that’s used for • . treatment of enuresis DDAVP: Synthetic analog of arginine vasopressin, it • .increases water reabsorption Oxybutynin: Anticholinergic and antispasmodic drug • that has a role in reducing uninhibited bladder .contractions
(Treatment (continue • Behavioral Therapy: The use of an alarm system to wake the patient up at a specific time. Hypnotherapy maybe implemented, teaching patient and family. • Motivational Therapy: Educating family about enuresis, giving printed handouts with instructions on how to manage the condition. Positive reinforcement, rewards.
Age related treatments Younger than age 8: Two important things with this age • .group are, reassurance and education Ages 8 through 11: Using the alarm system would work • .best for this age group, and also medication Ages 12 and older: Aggressive intervention is necessary, • .the alarm system and or medication
STATS of children still wet the bed at age 5 15% • to 10% of children still wet the bed at age 7 7 • of boys and 2% of girls still wet the bed at age 10 3% • of boys and very few girls still wet the bed at age 18 1% •
Age Stats Graph
Gender Stats Graph
Conclusion Enuresis or bedwetting can have a big impact on every aspect of that person life. One must learn to identify the problem and treat it appropriately according to the age group. The most effective way to treat enuresis is probably the alarm system and with medication.
Reference Works Cited Michael R. Lawless, M. a. (2001). Nocturnal Enuresis: Current .Concepts. Article Urology , 22 (12), 399-406 .Pack, M. a. (2007). Pediatric Parasomnias. Sleep , 30 (2), 147-148 Vicent Iannelli, M. (2008, 11 24). Bedwetting-Bedwetting Statistics. : Retrieved 2 13, 2014, from About.com Pediatrics http://pediatrics.about.com/od/bedwetting/a/1108_bedwetting.htm?p=1