Oh My, Wet Bed and Dry Mouth Lead to Wet Eyes

The association between childhood obstructive sleep apnea (OSA) and sleep enuresis has been known for some time. This case discusses current understanding of the pathophysiologic relationship between the two. The authors also discuss the current diagnostic criteria and standardized terminology of enuresis as developed by the International Children’s Continence Society and the American Academy of Sleep Medicine. Components of a sleep history and physical examination that are key to establishing the complex relationships between enuresis and OSA are reviewed. Hypotheses for the higher prevalence of sleep enuresis in patients with OSA are summarized. Although the treatment of OSA often results in reversal of enuresis, and the mechanistic pathways appear plausible, the strength of evidence in the literature that OSA causes enuresis in children is not very strong, and further research is warranted.