Obstructive Sleep Apnea
A study conducted in 2003 found that out of 160 children, aged 4-17 who were attending a sleep disorder clinic for suspected nighttime breathing problems, 66 of them, or 41 percent, were also bed-wetters. However, only a very small number of children wet the bed due to a problem called Obstructive Sleep Apnea (OSA). In OSA, there is a partial blockage or intermittent interruption in the flow of air to the child's lungs, and this is enough of a blockage or interruption to cause serious interference with his breathing.
The most common cause of childhood OSA is enlarged adenoids. The adenoids are located behind the nasal passages and like tonsils, are a type of lymph gland. In most children, large adenoids cause snoring. These children do not have OSA. According to Dr. Lee J. Brooks, a clinical associate professor of pediatrics at the University of Pennsylvania in Philadelphia, only about 10 percent of children snore, and only 10 percent of those who snore have sleep apnea.
In the 2003 study, breathing assessments were conducted while the children slept at the clinic. It was found that 47 percent of those children who experienced more than one breathing pause per hour of sleep wet the bed as compared with 27 percent of those children who had no breathing disturbances per hour, or just one.
Those few children who develop OSA stop breathing for short periods as they sleep. The continual interruption of their sleep during the night means that children with OSA never have a good night's sleep. Children with OSA may develop morning headaches and appear sleepy at school.
OSA leads to changes in the chemical balance of the body and in particular, the brain. Some physicians believe that this chemical imbalance is the cause of bedwetting in children with OSA. While the exact connection between OSA and bedwetting has not been determined, it is clear that in the few children who have this connection, the surgical removal of tonsils and adenoids ends bedwetting for good.
It's important to distinguish this small group of children from those who wet the bed and snore. Removing the tonsils and adenoids of children who snore and wet the bed is no guarantee that they will become dry at night. However, if your child began to snore at around the same time his bedwetting began, it's a good idea to mention this to your doctor. Sometimes the right questions and a thorough checkup will lead a doctor to determine that a child has OSA, an uncommon cause of bedwetting in children.