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Breathing problems and bed wetting

Breathing problems are to blame for many cases of bed wetting in children, and perhaps even in some adults too. And a simple treatment might solve the problem.

Breathing problems and bed wetting

Breathing problems are to blame for many cases of bed wetting in children and perhaps, even in some adults too. And a simple treatment might solve the problem.Much of the evidence comes from follow-up studies of children who have enlarged adenoids or tonsils removed. A 2001 study of 321 children found that over a third of them wet their beds prior to surgery. Of these, 63 per cent stopped completely three months after surgery. Other studies have produced similar results. But in most cases, a narrow palate rather than swollen adenoids or tonsils could be the cause of breathing problem. If the roof of the mouth is particularly narrow, the tongue is pushed back and can partly block the airway during sleep. In these cases, orthodontic devices similar to a brace can be used to widen the palate. A Swedish study found that seven out of 10 children who had all failed to respond to other treatments for bed wetting improved within one month of using such a device, with four completely stopping wetting their beds. Another small British study found bed wetting stopped in 10 out of 10 children given these devices. Researchers are about to start a larger study involving 100 children at the Prince of Wales Hospital. They track the children's sleep patterns and bed wetting episodes after installing the devices. If the results confirm those of the smaller studies, it could help persuade people to start taking the idea far more seriously.
Nobody quite understands how airway obstructions could lead to bed-wetting, but there are several theories. One is that breathing problems create a physical pressure in the abdomen that stimulates urination. Another is that the breathing problems lead to low blood oxygen concentrations, which in turn could affect levels of hormones involved in urine production, such as antidiuretic hormone (ADH).Bed wetting affects as many as one in 10 six-year-olds. While it usually resolves over time, some parents resort to medical treatments, such as a drug that inhibits urine production, or alarms that rouse the sleeper immediately wetness is detected. But this is just treating the symptom, not the cause. In the past, bed wetting has been blamed on everything from drinking too much liquid to stress or even child abuse. Doctors evaluating children with bed wetting problems should now examine their airways and ask about how they sleep and whether they snore in addition to looking at other possible causes. Identifying the proper cause is important. If breathing problems are to blame, they could have more serious consequences than bed wetting, such as problems at school, headaches and hyperactivity. And it is not just children who could benefit, evidence suggests that some adults with breathing problems such as sleep apnoea also wet their beds.

New Scientist, July 2003; Vol. 87 (8)
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