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Heart Hormone Elevated in Children Who Wet Bed
Date:5/5/2008

noring group, almost 90 percent of those with enuresis were boys.

"The risk of bed-wetting for children who snore was about threefold," said Gozal.

But, the researchers also found that the severity of snoring didn't appear to change the risk of bed-wetting when they examined a smaller group of 60 children who wet the bed during sleep lab studies. Twenty of the children had obstructive sleep apnea; 20 had habitual snoring but no sleep apnea, and 20 didn't snore at all.

The researchers did find that levels of a heart hormone, brain natriuretic peptide (BNP), were raised in children who wet the bed. That finding would seem to be related to snoring, according to Gozal, because snoring causes the upper airways to contract, which makes the chest muscles work harder to pull in air, which in turn creates pressure on the airways and blood vessels, which causes blood to return to and dilate the heart. Then, too much fluid collects and needs to be released, which is one of BNP's functions -- to increase sodium and water excretion around the heart.

However, if snoring was responsible for the elevated BNP levels, a more serious snoring problem should have caused even higher levels of BNP, but that wasn't the case.

"Clearly, this is a complex mix," said Gozal.

What parents need to know from this study is that if your child is predisposed to bed-wetting, any additional factors, such a snoring, may make bed-wetting more likely. So, if your child snores and wets the bed, Gozal said that treating the snoring may help reduce bed-wetting.

"This is a great study, and it's nice to see some of the science behind the problem," said Dr. Sangeeta Chakravorty, clinical director of the pediatric sleep program at Children's Hospital of Pittsburgh.

"Parents should know that 15 percent of children get better every year with no intervention," she said, but added, if bed-wetting persists after a child is 5 years old
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