Case report: Desmopressin and somnambulism

Abstract

Background: Nocturnal enuresis is caused by a mismatch between nocturnal urine production and bladder capacity. Together with a presumed decreased arousability, this results in an inability to awaken in response to a full bladder. According to recent findings, a disrupted sleep might play a role in the pathophysiology of enuresis. Case: A 7-year-old boy was diagnosed with primary nocturnal enuresis caused by nocturnal polyuria and a concomitant parasomnia, somnambulism. A polysomnographic study was performed before treating the nocturnal enuresis with the oral lyophylisate formulation of desmopressin (melt). After 1 day of treatment, both nocturnal enuresis and somnambulism disappeared. Treatment was ceased after six months. One week later, the child started to produce more urine and redeveloped nocturnal polyuria. Somnambulism reappeared followed by nocturnal enuresis two weeks later. The same treatment protocol was started up, resulting in disappearance of both nocturnal enuresis and somnambulism. Conclusion: This case report documents the beneficial effect of desmopressin melt on both nocturnal enuresis, caused by nocturnal polyuria, and a concomitant parasomnia in particularly somnambulism.

Share and Cite:

Herzeele, C. , Dhondt, K. and Walle, J. (2013) Case report: Desmopressin and somnambulism. Open Journal of Pediatrics, 3, 208-210. doi: 10.4236/ojped.2013.33037.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Hjalmas, K., Arnold, T., Bower, W., et al. (2004) Nocturnal enuresis: An international evidence based management strategy. Journal of Urology, 171, 2545-2561. doi:10.1097/01.ju.0000111 504.85822.b2
[2] Yeung, C.K., Diao, M. and Sreedhar, B. (2008) Cortical arousal in children with severe enuresis. The New England Journal of Medicine, 358, 2414-2415. doi:10.1056/NEJMc0706528
[3] Cohen-Zrubavel, V., Kushnir, B., Kushnir, J. and Sadeh, A. (2011) Sleep and sleepiness in children with nocturnal enuresis. Sleep, 34, 191-194.
[4] Mahler, B., Kamperis, K., Schroeder, M., et al. (2012) Sleep deprivation induces excess diuresis and natriuresis in healthy children. American Journal of Physiology— Renal Physiology, 302, F236-243. doi:10.1152/ajprenal.00283.2011
[5] Dhondt, K., Raes, A., Hoebeke, P., et al. (2009) Abnormal sleep architecture and refractory nocturnal enuresis. Journal of Urology, 182, 1961-1965. doi:10.1016/j.juro.2009.05.103
[6] Neveus, T. (2006) The evaluation and treatment of therapy-resistant enuresis: A review. Upsala Journal of Medical Sciences, 111, 61-71. doi:10.3109/2000-1967-026
[7] Guilleminault, C., Lee, J.H., Chan, A., et al. (2005) NonREM-sleep instability in recurrent sleepwalking in prepubertal children. Sleep Medicine, 6, 515-521. doi:10.1016/j.sleep.2005.03.003
[8] Guilleminault, C., Palombini, L., Pelayo, R. and Chervin, R.D. (2003) Sleepwalking and sleep terrors in prepubertal children: What triggers them? Pediatrics, 111, e17-e25. doi:10.1542/peds.111.1.e17
[9] Guilleminault, C., Poyares, D., Rosa, A. and Huang, Y.S. (2005) Heart rate variability, sympathetic and vagal balance and EEG arousals in upper airway resistance and mild obstructive sleep apnea syndromes. Sleep Medicine, 6, 451-457. doi:10.1016/j.sleep.2005.03.014
[10] Campbell, I.G., Grimm, K.J., de Bie, E. and Feinberg, I. (2012) Sex, puberty, and the timing of sleep EEG measured adolescent brain maturation. Proceedings of the National Academy of Sciences of the United States of America, 109, 5740-5743. doi:10.1073/pnas.1120860109
[11] Hublin, C., Kaprio, J., Partinen, M., Heikkila, K. and Koskenvuo, M. (1997) Prevalence and genetics of sleepwalking: A population-based twin study. Neurology, 48, 177-181. doi:10.1212/WNL.48.1.177
[12] Esposito, M., Gallai, B., Parisi, L., et al. (2013) Primary nocturnal enuresis as a risk factor for sleep disorders: An observational questionnaire-based multicenter study. Journal of Neuropsychiatric Disease and Treatment, 9, 437-443.
[13] Glazener, C.M.A. and Evans, J.H.C. (2002) Desmopressin for nocturnal enuresis in children. Cochrane Database of Systematic Reviews, Article ID: CD002112.
[14] Schulz-Juergensen, S., Rieger, M., Schaefer, J., Neusuess, A. and Eggert, P. (2007) Effect of 1-desamino-8-D-arginine vasopressin on prepulse inhibition of startle supports a central etiology of primary monosymptomatic enuresis. Journal of Pediatrics, 151, 571-574. doi:10.1016/j.jpe ds.2007.05.024
[15] Rahm, C., Schulz-Juergensen, S. and Eggert, P. (2010) Effects of desmopressin on the sleep of children suffering from enuresis. Acta Paediatr, 99, 1037-1041. doi:10.1111/j.1651-2227.2010.01724.x

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.