Sleep Parameters and Quality of Life in Children with Monosymptomatic Nocturnal Enuresis: Association, Prediction and Moderation Analysis

Leticia Soster, Renatha Rafihi-Ferreira (), Simone Fagundes, Adrienne Lebl, Vera Koch and Ila Linares
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Leticia Soster: Pediatric Division, Hospital das Clínicas, University of São Paulo, São Paulo 01246-903, Brazil
Renatha Rafihi-Ferreira: Department of Clinical Psychology, University of São Paulo, São Paulo 05508-030, Brazil
Simone Fagundes: Pediatric Division, Hospital das Clínicas, University of São Paulo, São Paulo 01246-903, Brazil
Adrienne Lebl: Pediatric Division, Hospital das Clínicas, University of São Paulo, São Paulo 01246-903, Brazil
Vera Koch: Pediatric Division, Hospital das Clínicas, University of São Paulo, São Paulo 01246-903, Brazil
Ila Linares: Department of Clinical Psychology, University of São Paulo, São Paulo 05508-030, Brazil

IJERPH, 2025, vol. 22, issue 5, 1-10

Abstract: Although often considered benign, monosymptomatic nocturnal enuresis (MNE) can significantly affect various domains of children’s quality of life. This study aimed to investigate the relationship between polysomnography-derived sleep parameters and quality of life in children with MNE. Forty-four participants aged 8–12 years, with a diagnosis of MNE, underwent polysomnography and completed a quality of life questionnaire (PedsQL). Multiple linear regressions were used to assess the role of sleep variables in predicting four PedsQL domains. Moderation analysis was also performed to evaluate whether the N2 sleep percentage influenced the relationship between arousals and PedsQL. A higher frequency of microarousals predicted lower scores in the physical (B = −3.28, p = 0.01) and social (B = −3.50, p = 0.004) domains. A higher N2 sleep percentage was associated with better social (B = 0.69, p = 0.03) and school functioning (B = 0.88, p = 0.03). Moderation analysis revealed that N2 sleep amplified the negative impact of arousals on the social domain, particularly when the N2 sleep percentage was one standard deviation above the mean (B = −4.31, p < 0.001). The findings underscore the importance of sleep continuity and N2 stability for the quality of life of children with MNE. These results demonstrate the complex interaction between sleep and quality of life in pediatric enuresis.

Keywords: monosymptomatic nocturnal enuresis; behavioral problems; polysomnography; quality of life (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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